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LIBRARY OF CONGRESS. 



ChapaLir/ Copyright No 

UNITED STATES OF AMERICA. 



A COMPENDIUM OF 

Domestic Medicine 

and Health Adviser 



CONTAINING 

A Statement of the Modes of Curing the 

Diseases to which Man is liable; and 

Directions in case of Accidents on 

the Road or at Sea; 

WITH 

A full Account of Epidemic Cholera, of 

Dyspepsia, and of Sick-Headache; 

their Causes,Cure and Prevention ; 

AND 

A popular Description of the Human 

Teeth; their Formation, Diseases* 

and Treatment. 

BY 

HENRY McMTJRTRIE, M. D. 




PUBLISHERS 

ALHAMBRA BOOK CO. 

CHICAGO. 



D 



U.ibr*" y *»* Com** 

Pv.v tarns Kta^eo 1 
* SEP 28 1900 

Com"?** «*j 
8£CC«0 COPY. 

0«<ttw*** *• 

ORDt* DWtSKW, 

OCT 18 1900 






i* 



\°\ 



Copyright 1900, 
Alhambfa Book Co. 



PREFACE. 



The practice of medicine should be conducted on 
those general principles, which are drawn by sober 
experience, from a careful observation of the effects 
of remedies upon the human body, in its different 
stages of disease. These great leading principles are 
few, short, and easily understood ; they are applica* 
ble in every disease to which the human body is 
subject, although they may not always prove equally 
successful. It is the judicious use of them which con- 
stitutes the great merit of the enlightened physician. 

In a matter of such immense importance to every 
individual, it would seem necessary then, that these 
principles be as widely disseminated, and in as plain 
words as possible, in order that every one may know 
and understand them. To do this, is every man's 
duty, as well as interest; for, independently of his 
own life, which is frequently jeoparded by the want 
of such knowledge, that of his neighbour is often by 
accident placed in his hands. 

To some particular sections of our extensive coun- 
try, and to travellers especially, this consideration is 
of the utmost importance. I have known a consider- 
able district in one of our western states, which con- 
tained but one doctor, and him I have met on his 
way to his patients by eight o'clock in the morning 
so drunk, as to render it necessary to lift him into his 
gig! Sometimes there is no physician of any kind to 
be obtained ; or if there be, after waiting until the 
complaint has got to a height that baffles all reme 
dies, he arrives in a state similar to that described ! 
What becomes of the sick, under such circumstances ? 
3 



4 Preface. 

It was on some such occasion, that the necessity 
of a cheap, plain work, like the present, first sug 
eested itself to my mind. Those books that have 
been intended for like purposes, seem to me toe 
bulky, too learned, or too expensive. In this work, I 
have endeavoured within a small compass, and in a? 
plain a manner as possible, to lay down such rules 
and give such directions, as will enable every one 
who reads them to adapt to his (or his friend's) case, 
the plan of treatment most proper for it. 

As these pages are intended exclusively for the 
use of men, no diseases peculiar to women or children 
are treated of in it. 

To the various writers to whose works J am in- 
debted, I have made no reference ; I have, however, 
made free use of the most valuable of such as are 
considered authorities, and in some instances have 
adopted their very words. 



The Publisher has issued " Plain Medical 
Talks to Women" — intended as a companion 
to the present work. See advertisement of title 
and contents at the end of this volume. 




SKELETON OF MAN. 



CONTENTS. 



PART FIRST. 

Introduction . . . . • .15 

1. General Rules for Treating Diseases . 15 

2. Hints to Travellers in Health . .17 

3. Hints to Invalids Travelling . .21 
Division of Diseases .... 23 

(Efjapter £. 

Of Fevers. 

Of the Pulse 25 

Of Fever 26 

Simple Inflammatory Fever . . 27 

Intermittent, or Fever and Ague 28 

Remittent Fever .... .30 

Bilious Fever .... .30 

Typhus, or Low Nervous Fever . . 32 

Putrid Fever 34 

Hectic Fever 36 

Chapter EX. 

Of Diseases, commencing in, and chiefly confined to, 
particular parts. 

Inflammation of the Brain .... 37 

Headache 38 

Inflammation of the Eye 38 

Dimness of Sight 39 

5 



6 Contents. 



Night Blindness 40 

Inflammation of the Ear . . . . .40 

Bleeding from the Nose 41 

Polypus .41 

Cancer of the Lip .... .42 

Mercurial Ulcers in the Mouth . . . .42 
Ulcers and Pimples on the Tongue . . .42 

Cancer of the Tongue 43 

Venereal Ulcers 43 

Enlargement of the Uvula . . . .43 

Swelling of the Tonsils 44 

Inflammatory Sore Throat 44 

Putrid Sore Throat or Diphtheria . . 45 

Strictures in the Throat 46 

Catarrh, or Cold 47 

Asthma 47 

Pleurisy . .48 

Spitting of Blood 49 

Consumption . . .... 49 

Palpitation of the Heart 60 

Dropsy of the Chest . . ... 51 

Inflammation of the Stomach . . .52 

Cramp in the Stomach 53 

Hiccoughs ....... 53 

Heart-Burn ....... 54 

Indigestion 54 

Vomiting of Blood . 56 

Inflammation of the Liver 56 

Jaundice . ...... 57 

Ague Cake 59 

Inflammation of the Intestines . . . .59 
Cholera Morbus, or Vomiting and Purging . 60 

Dysentery 61 

Diarrhoea ... .... 63 

Colic . 64 

Painter's Colic 65 

Worms: the White Thread Worm— the Round 

Worm — the Tape Worm .... 66 
Inflammation of the Kidneys . . . .69 
Gravel . 68 



Contents. 7 

Inflammation of the Bladder . .70 

Difficulty of Urine 70 

Suppression of Urine . .... 71 

Incontinency of Urine 72 

Stone in the Bladder 72 

Diabetes, or an Immoderate Flow of Urine . 73 
Dropsy of the Abdomen . . . ,73 

Tympany , 75 

Gonorrhoea . 75 

Gleet . 76 

Involuntary Emissions 77 

Strictures 77 

Syphilis 77 

Cancer of the Penis 78 

Venereal Warts 79 

Mercurial Disease 79 

Dropsy of the Scrotum 79 

Enlarged Spermatic Vein 80 

Cancer of the Testicle .80 

Impotency . 81 

Gout . . . .... 81 

Inflammatory Rheumatism . . . .82 

Chronic Rheumatism 83 

Hip-Joint Disease 84 

Dropsy of the Knee Joint . ... 84 

White Swelling ....... 85 

Pieces of Cartilage in the Joints . . .85 
Scrofula, or King's Evil .86 

Inflamed Glands .... .86 

Surrhus . . 87 

Cancer 87 

Goitre 88 

Fainting . .... .88 

Apoplexy . » .88 

Stroke of the Sun 89 

Epilepsy ........ 90 

Palsy 91 

Tetanus, or Cramp 91 

Locked -Jaw 92 

Painful Affection of the Nerves of the Face . 93 



8 Contents. 

Angina Pectoris . 94 

Dance of St Vitus 95 

Scarlet Fever .95 

Erysipelas, or St Anthony'g Fire . .96 

Mercurial Erysipelas 98 

Measles 99 

Chicken-Pox 100 

Cow-Pox 100 

Small-Pox 101 

ftch ... 103 

Herpes 103 

Scald Head 104 

Ring Worm 105 

Nettie-Rash 105 

Blotched Face 106 

Scurvy 106 

Of Tumours 108 

Of Ruptures: Reducible — Irreducible — Stran- 
gulated 108 

Aneurism Ill 

Tumours: Fleshy — Steatomatous — Encysted . 112 

Ganglion . 113 

Boils 114 

Carbuncle 114 

Whitlow, or Felon 115 

Piles: Blind— Bleeding 115 

Of Abscess 116 

Psoas Abscess 117 

Of Fistula . 118 

Of Ulcers : Inflamed — Fungous — Sloughing — In- 
dolent — Carious — Scorbutic — Scrofulous — 
Venereal 119 

dCfmjrter EK& 

Of Accidents, 

General Directions .... . 122 

Of Contusion .... .123 

Of Sprains . 124 

Concussion of the Brain ..... 124 



Contents, 



9 



f Mosq 



Compression of the Brain . 
Of Wounds 

To Stop the Bleeding 

Incised Wounds . 

Punctured Wounds 

Contused Wounds 

Poisoned Wounds, from Bites of Mad 
Rattle-Snakes, &c. . 

Stings of Bees and Wasps, Bites oi 

toes, &c 

Wounds of the Limbs, &c. 

Of the Ear, Nose, &c. 

Of the Scalp 

Of the Throat . 

Of the Chest 

Of the Abdomen . 

Of Joints .... 

Of Tendons 
Of Fractures .... 

Of the Bones of the Nose . 

Of the Lower Jaw 

Of the Collar Bone . 

Of the Arm .... 

Of the Bones of the Fore-Arm 

Of the Wrist, &c. 

Of the Ribs .... 

Of the Thigh 

Of the Knee-Pan 

Of the Leg . 

Of the Bones of the Foot 
Of Dislocations . 

Of the Lower Jaw 

Of the Collar Bone 

Of the Shoulder . 

Of the Elbow . 

Of the Wrist, Fingers, &c. 

Of the Thigh 

Of the Knee- Cap 

Of the Leg . 

Of the Foot . 



Dogs, 



125 
125 
125 
127 

129 
129 

130 



. 131 
. 131 
. 131 
. 131 
. 132 
. 132 
. 132 
133 
. 133 
. 134 
. 134 
. 134 
. 135 
. 135 
. 136 
. 136 
. 136 
. 137 



.137 
. 138 
. 138 

139 
. 140 
. 140 
. 140 

141 
. 141 
. 142 
. 142 

142 
. 142 



10 Contents. 

Of Compound lecidents 143 

Of Amputation 143 

Of Suspended Animation 143 

From Drowning . . . . • . .143 

From Cold 145 

From Hanging ...#.. 145 

From Foul Air 145 

Of Swallowing Poisons 146 

Acids 146 

Alkalies ... ... 147 

Mercury 147 

Arsenic 147 

Copper 148 

Antimony 148 

Salts of Tin 148 

Salts of Bismuth, Gold and Zinc . . 148 

Lunar Caustic 148 

Salt-Petre ... ... 149 

Sal Ammoniac 149 

Liver of Sulphur .... 149 

Phosphorus 149 

Spanish Flies .... .149 

Powdered Glass 150 

Lead 150 

Opium, or Laudanum . . . . 150 

Mushrooms 151 

Tobacco, Hemlock, Night-Shade, Spurred 

Rye 151 

Poisonous Fish 151 

Foreign Bodies in the Throat . . . .151 

Of Burns and Scalds 152 

Of Mortification 153 

Directions for Bleeding 154 

Directions for Passing Catheters — Bougies 154, 155 

Otfjaptcr XV. 
Prescriptions referred to in the work. 

Prescriptions . . • . . 156—160 

Mixtures, Saline— Effervescing. . . . 156 



Contents. 11 



Wine or Vinegar Whey . . 15? 

Scudamore's Lotion for Gout . . .159 

Poultices of various kinds .... 160 

Clysters of various kinds . . . .160 

Hartshorne's Decoction of Spanish Flies in Spirits 

of Turpentine . ... 160 



PART SECOND. 



EPIDEMIC, or ASIATIC CHOLERA . . 163 

Causes 164 

Predisposing and Exciting Causes . 164 

Prevention 16& 

Symptoms 167 

1. The Stage of Diarrhoea . . .167 

2. The Stage of Spasm . . .168 

3. The Stage of Commencing Collapse 168 

4. The Stage of Confirmed Collapse . 169 
Treatment in the different Stages . 169 

PVSPEPSIA, or INDIGESTION . . .174 

175 
178 
180 
181 
183 
185 



Causes 
Symptoms . 
Prevention . 
Treatment . 

1. Costiveness 

2. Flatulence 

3. Violent Pain of Stomach and Bowels 185 

4. Nausea and Vomiting . . . 186 

5. Constant Soreness and Pain of the 

Stomach 186 

General Remedies 187 

1. The Warm Baih and Frictions . 187 

2. Mr Halsted's Method . . .188 

3. Mineral Waters ... 189 

4. Tonics and Bitters . .189 
vTonrlusion . . 190 



12 



Contents. 



SICK-HEADACH 191 

Symptoms ... ... 192 

Medicines . . .... 193 

Diet ...... .196 

L>.>ks ... .... 203 

Exercise . .... 206 

Change of Air 207 

Other Cautions 207 

Treatment of an Attack of the Complaint . 210 



THE TEETH . ... .212 

Structure, Number, Form and Articulation 213 
Formation of the Teeth . . . .218 

1. Formation of the Milk Teeth . . 218 

2. Formation of the Permanent Teeth 220 

Shedding the Teeth 220 

The First Dentition 223 

Diseases attending Difficult Dentition . . 226 
Diseases of the Teeth ... .229 

Caries or Rottenness . . . 230 

Diseases of the Fangs of the Teeth . 233 
Toothach . . . . .234 

Tartar, or Scurvy of the Teeth . . 236 

Diseases of the Alveolar Processes . . 238 

Diseases of the Gums 240 

Inflammation and Sponginess of Gums 240 
Gum-Boils ... . 241 

Tumours of the Gums . . . 241 

Cleaning the Teeth 242 

Excellent Tooth Powder . . .245 

Operations on the Teeth .... 245 
Extraction of the Temporary Teeth, 

when Diseased .... 245 
Lancing, or Cutting the Gums, at the 

time of Teething . . . .246 
Filing or Sawing the Teeth . 248 

Filling Teeth with Gold or other Metals 249 
Scaling: the Teeth, or Removal of Tartar 250 
Extracting Teeth . . . .250 

Artifirial Teeth . .... 252 




ARTERIES OF THE HUiMAN BODY. 

6. Iliac. — 7. Sacral. — 8. Renal. — 9. Intercostal. — 10. Aorta. 
11. Subclavian.— 12. Carotid.— 13. Vertebral.— 14. Tem- 
poral. — 15. Curvature of the Aorta. — 16. Axillary. — 17. 
Brachial. — 18. Coeliac— 19. Mesenteric arteries. — 20. 
Radial. 



PART FIEST. 



A STATEMENT 

OF THE MODES OF CURING THE DISEASES 
TO WHICH MAN IS LIABLE; 



DIRECTIONS 

FOR HIS CONDUCT IN CASE OF ACCIDENTS 
ON THE ROAD OR AT SEA 



INTRODUCTION. 



GENERAL RULES FOR THE TREATMENT 
OF DISEASES. 

All diseases might, with great propriety, be arranged 
under three heads, viz. 

Inflammatory diseases, or those attended by in- 
creased action, as shown by a .quick, full, hard or 
strong pulse, — great thirst and heat, — white, or red 
tongue, — flushed face, — bloodshot eye, &c. &a 

Diseases of debility, accompanied and marked by a 
small, soft, feeble, slow, or intermitting pulse, — a 
shining white or dark tongue, — languor and weak 
ness, — cold clammy or burning skin, and an internal 
sense of sinking. 

Diseases either of increased or diminished action, 
producing particular effects, and requiring peculiar 
remedies. 

Although I have not thought proper, (for reasons 
presently to be mentioned) to adopt this arrangement, 
I. have been induced to glance at it, as giving rise to 
those great leading principles or rules, which should 
govern us in the management of all diseases, and 
which, if attended to, will be followed by conse- 
quences as beneficial as the nature of the circum- 
stances will admit 



In every complaint, whatever it may be called, if 
you find tne pulse quick, hard, full, and strong, — the 
nead ache, — tongue foul, — skin hot, or those marks 
15 



16 Compendium oj Domestic Medicine. 

which denote it of an inflammatory nature, reduce 
it by purging, — low diet, — drinking plentifully 
of cold water and lemonade, — rest, Ac. 

RULE II. 

If on the contrary, the pulse be small, soft, feeble 
and intermitting, — trie tongue dark, and great debility 
or weakness is evident, reverse the whole plan , the 
diet must be generous and nourishing, — the bcwela 
opened with gentle laxatives, — and the strength sup 
ported by bark, sulphate of quinine, wine and tonic* 
of various kinds. 



If in addition to those symptoms mentioned in the 
second rule, the tongue be covered with a black coat, 
— foul dark looking sores form about the gums and 
insides of the cheeks, — the breath be offensive, &c. 
the same class of remedies is to be vigorously em- 
ployed, with a free use of acids and other antiseptic 
articles 

RULE IV. 

Severe local pains, as in the head, side, &c., re- 
quire sometimes the use of purging, and blisters 
to the part. 



Incessant and earnest entreaties on the part of the 
sick, for any particular article of diet, if steadily per- 
severed in, may be safely indulged, whether ihe use 
of it agrees or not with our preconceived ideas on the 
subject 

RULE VI. 

In all fevers, where the pulse is quick, full and 
strong, — the skin burning to the touch, and there is 



General Rules 1; 



no perspiration, dash cold water over the head and 
shoulders of the patient, wipe him dry and put him 
to bed. If in consequence of this, a chill be experi- 
enced, and the pulse sink, give warm wine, &c. and 
omit the water for the future. Should a pleasant 
glow, over the whole frame, follow the affusion, and 
the patient feel relieved by it, repeat it as often as 
may be necessary 



Observe carefully, the effects of various articles of 
food, as well as physic, upon your own body, and 
choose those which experience proves to agree best 
with you. It is a mlgar but true saying, that " What 
is one man's meat, is another's poison." 



Keep a sick room always well ventilated. Plenty 
of fresh air is ar \mportant remedial agent in all dis- 
eases. 



HINTS TO TRAVELLERS IN HEALTH. 

The sudden changes of weather, which so particu- 
larly characterize the climate of the United States, 
render a supply of flannel to be worn next the skin 
a matter of much consequence to the health and 
comfort of the traveller, who is more exposed than 
others to the morning and evening damps, as well as 
the meridian heat. 



As a general preservative of health, I know of no 
habit more valuable than this; the disagreeable irri- 
tation of tb^ skin it occasions at first, soon wears off 
P 



18 Compendium of Domestic Medicine. 

and it then becomes pleasant. The objections to it 
during the summer months, are more specious than 
solid. Accustomed to be cased in it from head to 
foot, in the East and West Indies, as well as in the 
southern parts of America, I have uniformly had oc- 
casion to remark that I suffered less from the hea f 
than such of my friends as wore none. This Is now 
generally admitted to be the consequence by scien- 
tific men, and is easily accounted for on principles, 
with which my limits do not permit me to meddle. 
I merely mention the fact, and again seriously recom- 
mend every one who wishes to preserve his health 
in this climate, to have immediate recourse to flannel, 
and never to leave it off 



A phial of laudanum, one of strong essence of 
peppermint, with a bottle of brandy, and a box 
of vegetable cathartic pills, should always have 
a corner in every traveller's trunk : they take up 
but little room, and should he proceed without 
them, a few days, perhaps hours, may give him 
serious cause to regret it. 

While in a high healthy country, there is no abso- 
lute necessity for observing the following rules, which 
become indispensable while in a low, marshy, and 
consequently a sickly one. Never leave your sleeping 
place in the morning, until the fog and damp have been 
dispersed by the sun ; if, however, you are not master 
of your own movements, and cannot avoid it, always 
endeavour to have a cup of coffee and a crust of 
bread before you set out; this can generally be had, 
by speaking to the landlord the preceding evening. 
If you are disappointed, a glass of wine with a few 
drops of peppermint and a little sugar in it, will an- 
swer; and in default of the wine, spirits of any kind 
prepared in the same way, with or without bitters. 
By these means your stomach will be fortified, and 
one great avenue to disease be blocked up, alway? 



Hints to Travellers in TfenUh. 19 



recollecting that it is as a medicine yon aro to take 
it, not to gratify your palate. The practice is unfor- 
tunately too apt to be continued, \* hen all necessity 
for it has ceased, and mint julept, like some other 
good things that are abused, have wrecked many an 
honest and good man: coffee should always be pre- 
ferred if it can be obtained. 



To mention the propriety of examining closely, the 
beds you are to sleep in, may at first sight seem su- 
perfluous, to say nothing more of it. It is not, how- 
ever, the refreshing luxury of clean sheets, that is 
the principal inducement to caution, but the great 
risk you run of contracting disorders by sleeping in 
dirty ones. I have known a want of care in this 
point, punished by a severe disease. Many trouble- 
some and disgusting diseases of the skin, are com- 
municated in this way, without any idea being enter- 
tained of their origin. For my part, a great coat and 
a clean plank, a sofa or three chairs, would be pre- 
ferred to running any risk whatever. 

TOWELS AND SOAP. 

Every one should carry towels and soap with 
them when travelling, for the simple reason that 
at many stopping-places no soap is to be fo^nd, 
and towels are so scarce that many persons use the 
same ; which is a pernicious habit, as many con- 
tagious diseases of the skin and eyes have been 
transmitted in this way. 



Change of water is very apt to produce some little 
disturbance in the bowels, and this to a stranger is 
one of the sure marks of being in a lime-stone coun 



'10 Compendium of Domestic Medicine. 

try. If it act gently, it need not be minded, if other 
wise, mix wine, porter, or brandy with it, or omit the 
use of it altogether, for a few days, when it may be 
gradually resumed ; in this way its effects are dimin- 
ished. 

COLD. 

To prevent as much as possible any danger from 
frost, while travelling in excessively cold weather, 
having well cased your whole body (and feet in par- 
ticular) in warm clothing, avoid approaching the fire, 
and the use of spirits, or hot drinks of every descrip- 
tion. When you stop on the road, instead of seating 
yourself by the chimney and calling for liquor, walk 
about in the open air as rapidly as possible, and if 
you are thirsty, take a glass of cider or cold water. 
Three men (with one of whom I am personally ac- 
quainted) set out from Boston for Upper Canada, 
during the middle of a very severe winter, e ich one 
•driving his own sleigh; two of them were in the 
habit of stopping at eveiy tavern they came to, 
warming their feet and drinking freely of hot toddy. 
The other never entered a house, except for his 
meals or to sleep ; while his horse rested, he stretched 
his legs, and when he was thirsty he partook of the 
same element with his beast. The consequence of 
this was, that out of the three, he was the only one 
who arrived at his journey's end uninjured. One of 
his companions had his feet so badly frost-bitten, that 
he lost them both, and the other was taken out of his 
sleigh, at the door of a tavern, where his horse natu- 
rally stopped, frozen to death! If, notwithstanding all 
your care, you become much affected by the cold, 
beware of going to sleep : no matter how strong the 
inclination may be, resist it for your life — it is the 
sleep of death! 

NIGHT AIR. 

On retiring, it is well to close the window over 
the bed. One of the most fruitful sources of sick- 



Hints to Travellers in Health. 21 

ness, is found in the night air, that is generally damp, 
and loaded with poisonous vapours, and which, from 
the relaxed state of the body during sleep, is more 
apt than at any other time to produce the most mis- 
chievous effects. 

OCT Never let false delicacy, or any other cause, pre- 
vent you from emptying the bladder as often as you 
feel the inclination : a painful and lingering, some- 
times an incurable disease arises from neglecting this 
call of nature. 



HINTS TO INVALIDS TRAVELLING. 

Although the preceding directions apply to all tra- 
vellers, they should be more particularly studied and 
observed by invalids who, while travelling by land, 
either for the restoration of their health, or from ne- 
cessity, in stages or carriages, will find an advantage 
in observing the following rules. 



Never commence your journey m the morning 
until you have breakfasted and emptied the bowels, 
or endeavoured to do so. To obtain the wished foi 
result, make it a regular practice to solicit the evacua- 
tion directly after your meal. 



During the summer, never pursue your journey, if 
you can avoid it, in the heat of the day: it is better 
10 borrow an hour or two from the morning, and one 
from the evening, than to risk the excitement liable 
to be produced by a broiling sun. 

RULE III. 

Make short stages ; always remembering that ever 



22 Compendium of Domestic Medicine. 

cise should never be pushed to fatigue — the latter 
is as injurious, as the former is beneficial. 



Be careful to have no ligatures about your 
body — wear your cravat and garters loosely tied, 
and let all your clothing be easy. The flannel 
shirt is indispensable. 



Always have an ample cloak in the carriage ; 
early in the morning and in the evening, even of 
summer days, you may find occasion to use it with 
pleasure and profit. 

Always have a complete suit of winter clothing 
in your trunks, although you be travelling in the 
month of July : if the weather becomes cool, on* 
with your woollens, — stockings included. Inat- 
tention to the simple rule of adapting the clothing 
to the temperature of the air in its extreme 
changes, kills hundreds yearly. 

RULE VI. 

Never hesitate a moment to comply with the 
calls of nature; much mischief is occasioned by 
deferring these evacuations. It is better to be 
accused of a want of delicacy, than to have a 
suppression of urine or a fever and headache. 



This is the golden rule, and is of high authority. 
Keep your body open, your feet dry and warm, and 
your head cool ! ! 



A 

COMPENDIUM 

OF 

DOMESTIC MEDICINE. 



DIVISION OF DISEASES. 

It is a matter of no consequence with what par- 
ticular complaint we begin, since each one is to be 
described. All systems are artificial and liable to 
objections, but for the purpose of enabling every one 
to find out his ailment, and to refer at once to its 
mode of treatment, I have adopted. the following 
plan. In some points of view it may be exceptiona- 
ble, but it suits the purpose I intend it for, — the con- 
venience of my reader, who may possibly care as 
little as I do, whether the arrangement be scientific 
or not In the first place, there are such diseases as 
produce a general disturDance, that is visible through- 
out the whole body. These are found in fevers. 

Simple Inflammatory Fever. 

Intermittent, or Fever and Ague. 

Bilious Remittent Fever. 

Typhus or Low Nervous Fever. 

Putrid Fever. 

Hectic Fever. 

r 

Next we have those whose effects, though extended 
to the whole body, commence in, and are chiefly con- 
fined to, particular parts, such as diseases incident tc 

23 



24 Compendium of Domestic Medicine. 

1. The Head, 2. Throat, ~~"* 

3. Chest, 4. Stomach, 

5 Liver, 6. Intestines, 

7 Kidneys, 8. Bladder, 

9. Genital Organs, 10. Joints, 

11. Nerves, 12. Glands, 

13. Cellular Membrane,* 14. Skin, including Tu- 
mours, Ulcers, &c. 

Lastly, under the title "Of Accidents," will be con- 
sidered all those unfortunate occurrences, which are 
daily thinning the ranks of society, which human 
prudence cannot always prevent, and to which all 
who travel by land or water are more particularly 
exposed. 

* This is a kind of fatty net- work, lying immediate 
iy under the skin, and covering the whole body 




ARTERIES OF THE HUMAN EXTREMITIES. 

L Tarapl.— 2. PereimaE— 3. Posterior tibial.— 4. Anterior 

til ial.— 5. Femoral.— 21. Ulnar. 



CHAPTER I. 

Of Fevers : or those diseases which product a geneied 
disturbance throughout the whole body. 



OF THE PULSE. 

The pidse is nothing more than the beating of an 
artery.* Every time the heart contracts, a portion 
of blood is forced into the arteries, which dilate or 
swell to let it pass, and then immediately regain their 
former size, until by a second stroke of the same or- 
gan, a fresh column of blood is pushed through them, 
when a similar action is repeated. This swelling 
and contracting of the arteries then constitute the 
pulse, and consequently it may be found in every 
part of the body where those vessels run near enougn 
to the surface to be felt. Physicians look for it at the 
wrist, from motives of convenience. 

The strength and velocity of the pulse vary much 
in different persons, even in a state of perfect health. 
It is much quicker in children than in adults, and in 
old men, it grows more slow and feeble, owing to the 
decreased energy of the heart The pulse is increased 
both in strength and velocity by running, walking, 
riding, and jumping; by eating, drinking, singing 
speaking, and by joy, anger, &c. It is diminished in 
like manner, by fear, want of nourishment, melan- 

* There are two kinds of blood-vessels in the body : 
arteries and veins. The arteries carry the blood from 
the heart to the extremities of the body, where they 
are connected with the veins which bring it back 
*gain. An artery pulsates or beats; a vein does not 

25 



26 Compendium of Domestic Medicine. 

choly, excessive evacuations, or by whatever tends 
to debilitate the system. 

In feeling the pulse then in sick persons, allowance 
should be made for these causes, or what is better, 
we should wait until their temporary effects have 
ceased. 

A fully tense and strong pulse, is when the artery 
swells boldly under the finger, and resists its pressure 
more or less; if, in addition to this, the pulsation be 
very rapid, it is called quick, full, and strong; if slow, 
the contrary. 

A hard, corded pulse,, is that in which the artery 
feels like the string of a violin, or a piece of tightened 
cat-gut, giving considerable resistance to the pressure 
of the finger. 

T7ie sqft t and intermitting pulses, are easily known 
by their names. In cases of extreme debility, on the 
approach of death, and in some particular diseases, 
the artery vibrates under the finger like a thread. 

In feeling the pulse, three or four fingers should be 
laid on it at once. The most convenient spot to do 
this, as already mentioned, is the wrist, but it can be 
readily done on the temple,— just before, and close to 
the ear, — in the bend of the arm, — at the under part 
of the lower end of the thigh, among the ham-strings, 
— and on the top of the foot. 



OF FEVER. 

Fever is, by far, the most common complaint to 
which the human body is subject It may be briefly 
described as a combination of heat, — thirst, — loss of 
appetite, — weakness, and inability to sleep. It makes 
its appearance in two ways: either suddenly and vio- 
lently, or gradually and gently. When it comes on 
in the first manner, a cold snaking, attended with 
sickness at the stomach, or vomiting, marks its access : 
tl>c rold is more severe than in the latter, as is also 



Fever. 27 

the pain in the head, and other symptoms. When its 
attack is gradual, a feeling of soreness over the whole 
body, such as is experienced after a hard day's work 
by one not accustomed to it, shows its approach. 
Nausea, pains in the head, chills, and more or less 
heat and thirst soon follow. 

As these symptoms vary infinitely in their degrees 
of violence, the vigour of the treatment to be pursued, 
must differ accordingly. Thus the same directions 
that are given for simple inflammatory fever, must 
be adhered to, in one whose symptoms are lighter, 
though similar, only there is no necessity for pushing 
them to so great an extent. 



SIMPLE FEVERS. 

A fever not due to any one specific cause, 
lasting from one to ten days. 

Symptoms. Chills, — flushed face, — skin hot, — 
eyes red, — pulse quick, full, strong and regular, 
— great thirst, — tongue white, — urine high col- 
ored and small in quantity, — bowels consti- 
pated,— and breathing quick, etc. 

Causes. Cold, — violent exercise while ex- 
posed to the heat of the sun. — intemperance,— 
improper food, — deranged digestion,— the poison 
of one of the continued fevers too mild to pro- 
duce recognizable effects 

Distinguish it from other fevers by the 
abruptness with which it comes on, by the 
absence of symptoms peculiar to other fevers 
and by the rapid recovery. 

Treatment. Rest in bed in a cool, quiet room, 
Open the bowels with liquid citrate of mag- 
nesia or epsom salts. If there be great pain in 
the head apply cloths wrung out of cold wal^r, 
changing them often enousrh to keep tn^^ 
cold, or place an ice bag partially filled wiilr 
broken ice on the head. If the heat of tbe body 
be excessive and burning to the touch, and 
there is no perspiration, sponge the entire body 



28 Compendium of Domestic Medicine. 

and limbs with tepid or cold water. This is to 
be performed by removing all clothing-, wrap- 
ping the body completely in a thick blanket, 
and applying the sponge between the folds of 
the blanket, in order to protect from draughts, 
spending from ten to twenty minutes in the act 
of sponging; then teither remain in blanket 
until dry, or use towels, after which the cloth- 
ing and bed covering may be replaced, always 
practicing care not to wet the clothing or bed- 
ding because by so doing a cold might be con- 
tracted. There should be no fear of bad con- 
sequences from sponging if done in this manner, 
and it is an infallible and satisfactory means of 
reducing almost all the different kinds of fever. 
In addition to the sponging a tablespoonful of 
the spirits of Mindereri may be taken every two 
hours. These measures arejto be repeated with 
sufficient frequency to keep the skin moist and 
as nearly as possible to normal temperature, 
until the disease is overcome. Moderate doses of 
quinine should be taken during convalescence. 
The diet should consist of cool drinks, milk 
and beef tea. 



INTERMITTENT OR MALARIAL 
FEVER.— FEVER AND AGUE. 

Of this fever, there are several varieties,, 
which differ from each other only in the length 
of time that elapses between their attacks. 
There is one called quotidian, in which it comes 
on every twenty -four hours; another named 
tertian, in which it arrives every forty-eight 
hours, and the third quartan, because the inter- 
vals last seventy-two hours. 

Sysiptoms. The symptoms of fever and ague 
commence with yawning, stretching and 
uneasiness; this is succeeded by slight chills 
or shiverings, that end in a violent or con- 
vulsive shaking of the whole body. This 
is the cold fit, and is immediately followed by 



Fever and Ague. 29 

the fever or hot fit. The pulse rises, — the skin 
becomes hot, — pain in the head, — tongue white, 
and all the marks of fever, terminating in a pro- 
fuse sweat, which gradually subsiding, leaves the 
patient in his natural state, though somewhat 
weakened. 

Causes. Is supposed to depend upon the influ- 
ence of malaria, a poison emanating from decaying 
vegetable matter in low marshy localities, and is 
frequently developed in previous healthy localities 
by turning up the soil, and clearing the lands of 
new countries. Water absorbs and transmits this 
miasmic poison to the system, and it is more 
abundant during the night. 

Treatment. This consists first in the prevent- 
ive, by maintaining of as near a standard of health 
as possible, by a properly regulated diet and pro- 
tection from the night air. Sleeping in the upper 
stories of houses in malarial districts, and the 
closure of doors and windows on the side exposed 
to marshes or stagnant ponds. As soon as there 
are symptoms indicative of the approach of this 
disease, give at once a large dose of sulphate of 
quinine: to adults 10 to 20 grains, to children 4-6 
years old 3 to 5 grains, and from 10-14 years 6 to 
7 grains. When the fever comes on after the rigors 
and chills, soak the feet in hot water with a little 
mustard in, place in bed, cover lightly, and give 
some sweet spirits of nitre; tr. aconite, largely 
diluted, or a saline fever mixture. If the fever is 
very high, sponge the spine and whole body with 
tepid water. After the fever has passed off, renew 
the dose of quinine to prevent the return of the 
disease. If, however, it is not cut short by these 
means, and 'he quinine has no effect, combine it 



30 Compendium of Domestic Medicine, 

means, and the quinine has no effect, give 
Fowler's solution of arsenic combined with 
very minute doses, l-60th grain of strychnia. 
Of the Fowler's solution give 5 to 8 drops, three 
times daily to an adult. 



YELLOW FEVER. 

A fever which becomes epidemic in tropical 
and subtropical countries and does not spread 
at a temperature below 70°. As the sanitary 
measures have been bettered in the southern 
states the ravages of this disease have been 
decreased. It is characterized by an orange or 
bronze discoloration of the skin and in severe 
cases by the black vomiting and tarry stools. 



TYPHUS FEVER. 

This is a contagious fever, which was 
formerly known as ''jail fever," "camp fever," 
"ship fever," "spotted fever," and which owing 
to modern sanitary precautions has become 
obsolete. 



PNEUMONIA— LUNG FEVER. 

An inflammation of the lung tissue. Two 
clinical varieties are most frequently met with, 
viz.: Acute or lobar, and broncho-pneumonia. 
Lobar pneumonia has its starting point in the 
air cells and involves one or more lobes of 
either right or left lung or both, while broncho or 
lobular pneumonia nearly always follows some 
pre-existing disease and has its beginning 
in the bronchial tubes, and involves one or 
more lobules. 

Symptoms. Acute pneumonia is usual!;' 
ushered in with a chill, and a rapid rise :i- 
temperature, — a dull pain on the affected side, 




THE EYE. 
A, Lens. B, Aqueous humor. C, Yitreous humor. D, 
Retina. E, Iris. F, Choroid. G, Sclerotica. H, Cor- 
nea. I, Optic nerve. K, Ciliary process and muscle. 



Lung Fever. 31 

—a dry hacking- cough, — cheeks highly flushed, 
— tongue dry and coated, — breathiDg rapid and 
shallow, — expectoration clear and tenacious, 
at first becoming- bloody or rust-colored on 
third day,— countenance anxious,— frequently 
restlessness and delirium. The right side is 
the most often affected, and there is an immo- 
bility of the chest over that portion of the 
lung- involved. The urine is dark and the 
bowels are slightly constipated. In lobar 
pneumonia, on about the 7th or 9th day, the 
patient passes through the crisis, the tem- 
perature falls to normal or below normal, and 
the breathing- becomes clear. Broncho-pneu- 
monia occurs in connection with some other 
disease, and the primary symptoms are the 
same as in bronchitis, though the respiratory 
symptoms are as a rule the same as in lobar 
pneumonia. 

Cause. A specific micro-organism. Predis- 
posing and exciting causes, — overcrowded and 
improperly ventilated rooms, — exposure to 
wet, or sudden changes of temperature, — in- 
halation of irritant or foreign substances, — 
injuries to chest, and some preceding affec- 
tion. 

Distinguish it by the sudden onset of the 
fever, — the dry hacking cough, — the dull pain 
in side, — the anxious countenance, — the rapid 
and difficult breathing, — and by the brick dust 
color of sputum after the third day. 

Treatment. This is one of the most fatal of 
acute diseases, and whenever possible the 
patient should be cared for by a trained nurse, 
under the close direction of a physician. A 
majority of the cases that die, could be saved 
by having a skilled and faithful nurse at the 
bedside throughout the disease. Lobar pneu 
monia is bound to run a definite course in 
spite of remedial measures, while broncho* 
pneumonia, under judicious management may 
be cut short at any stage, though it is more 
likely to be a prolonged illness. The patients 



32 Compendium of Domestic Medicine. 

bed should be in a well ventilated room, kept 
at an even temperature of about 60° or 65°. The 
external application of an oiled silk jacket 
proves nearly always satisfactory. This is 
made of a layer of cotton baiting or wool, y t 
inch thick, held in place by a lining of cheese 
cloth, and covered on the outside with oiled 
silk. This should be cut and shaped so as to 
make a close fitting jacket, extending 1 from the 
last ribs to the throat, and fasten with safety 
pins. Ice bags or hot poultices should never 
be applied excepting under the special direc- 
tion of physician, for they are irritating to the 
patient, and because of their weight interfere 
with the breathing. Parti cular attention must 
be given to sustaining the vital powers by the 
use of a stimulating liquid diet, such as will 
not waste energy by taxing the digestion or in- 
terfere with respiration by dilating the stom- 
ach. The fever is to be reduced and the rest- 
lessness and delirium quieted by cold spong- 
ing or the cold wet-pack. The nourishment 
should be given from an invalid's drinking cup, 
or through a drinking tube; and the patient 
should never be allowed to sit up to void urine 
or evacuate the bowels, but should use a bed- 
pan, because movements or exertion are 
liable to spread the disease into healthy lung 
tissue, and what is more to be dreaded, a clot 
may be carried to the heart and produce in- 
stant death. Inhalations of oxygen are to be 
resorted to when the breathing becomes very 
difficult. This gas comes in tanks prepared 
for the purpose. 



REMITTENT MALARIAL FEVER. 

This name is applied to a type of malarial 
fever, in which the fever occasionally abates, 
but does not entirely cease, before a fresh attack 
comes on, so that the patient is never com- 
pletely free from it. The treatment is the same 



Typhoid Fever. 33 

as in the intermittent form of Hit disease. If 
there is vomiting, hold pellets cf ice in the 
throat and let them dissolve, which serves 
also furthermore to allay the burning thirst, 
usually present. Diluted limewater is another 
remedy for this purpose. And whenever this 
state exists the best article of diet is milk and 
limewater, and this may be given in the pro- 
portion of equal parts of each if the vomiting 
be persistent. Kumyss also agrees favorably 
with the stomach. When the fever continues at 
a high degree, the body may be wrapped in 
sheets wrung out of cold water or the patient 
may get into a cold bath. 



TYPHOID FEVEE. 

Symptoms. Languor, —debility,— dejection of 
mind,— alternate flashes of heat and chills, — 
loss of appetite, — disturbed sleep, — confusion 
of ideas, — aching of limbs, — ordinarily there 
are spells of diarrhea. These are succeeded by 
vertigo, — pain in the head,- vomiting and pain 
in abdomen, — fever, which grows worse toward 
night,— tenderness in lower part of right side 
of abdomen, with gurgling sound upon pres- 
sure, — after a few days the stools become yel- 
low, thin and very offensive. During the 
second and third weeks, rose-colored spots fre- 
quently appear on abdomen and chest, and 
after a few days fade away and are replaced 
by a new crop, — the tongue is covered with a 
white, yellow, or brown fur, and is shining red 
at the tip. The temperature runs a course 
which is denominated the typhoid temperature. 
The evening temperature is invariably 1° or 2° 
higher than that of the morning, throughout 
the attack, and for th^ Srst week there is in- 
crease of S° ea^h day, then follows a period of 
irors e<oi tsar.pe?atrr?, *vhich lasts until the 
*<>ver £eclJT>es 

Uausb. Tbe l-ypbo<d bacillus, which gener- 



34 Compendium of Domestic Medicine. 

ally gains access to the body in the drinking 
water or food, and attacks the Peyer's patches 
of the intestine, and sets up an inflammation 
of the intestinal mucus lining. 

Distinguish it by the character of the tem- 
perature, which risss and falls every twenty- 
four hours, and which has an ascending period 
for the first five to ten days, and then a station- 
ary period of from one to three weeks, followed 
by the period of decline, — by the diarrhea and 
offensive stools, — by the tender abdomen and 
by the few red spots which may appear and 
disappear over the body. Sometimes it is im- 
possible to distinguish this fever from one of 
the other lingering fevers, until a physician 
makes a microscopical examination of the 
blood. 

Treatment. This is always a serious 
disease and should, in every instance be 
under the close surveillance of a physician. 
More depends on the nursing and the careful 
following of the physician's directions than on 
the kind of medicine used. What has been 
said about sponging, the wet pack, and cold 
baths in the treatment of other fevers, applies 
particularly well here. The remedies to be 
given internally are intestinal antiseptics, in- 
tended to destroy the micro-organisms, and 
heal the inflamed mucus membrane in the in- 
testine. The diet is the most important factor 
throughout the disease. Cooling drinks must 
be frequently given, care must be exercised 
that the patient has a sufficient amount of 
nourishment, and this must be of a quality not 
to tax the enfeebled digestive powers, or be a 
bulky irritant in the intestinal tract. To fill 
these indications, milk, kumyss, beef tea, and 
the meat broths are among the best articles. 
This fever is bound to run a course of from 
two to eight weeks, in spite of every effort 
made to combat it. The convalescent patient 
must continue on a restricted diet for one or 
two weeks after fever is broken. The stools 
and urine should be disinfected by being kept 



Appendicitis. 35 

in a closed vessel for an hour, containing one 
or two per cent, solution of chloride of lime, 
and then buried ; and all bedding, clothing and 
eating- utensils should be scalded each time 
after the patient is through using them. 



HECTIC FEVER. 

This is never a primary disease, but is al- 
ways found as a symptom of some other one, 
as consumption. 

Symptoms. Night sweats,— bowels costive 
at first, then loose, — alternate chills and 
flushes, — a circumscribed spot on the cheeks, 
— a peculiar delicacy of complexion, and emaci- 
ation to so great a degree that the patient 
sometimes looks like a living skeleton. 

Causes. The absorption of matter from ab- 
scesses, as in consumption and scrofula. 

Treatment. Remove the cause, by curing 
the disease of which it is a symptom. 



APPENDICITIS. 

An inflammation of the appendix vermiformis, 
or of that worm-like portion of the intestines 
which is open at but one end. The character 
of this inflammation may be catarrhal or ulcer- 
ative to the degree of perforation. 

Symptoms. Pain and tenderness of variable 
severity in the right iliac region, most intense 
at a spot located half way between the um- 
bilicus and the crest of the hip bone ; and some- 
times a swelling may be discerned in this local- 
ity. The right thigh may be flexed, with 
pain in right side of abdomen when extension 



36 Compendium of Domestic Medicine. 

is attempted. There may be an initial chill and 
likewise vomiting. Usually the pain is acute, 
and there is a fever of from 101° to 103°, together 
with an accelerated pulse. A very rapid or 
irregular pulse is an unfavorable symptom, as 
is also sigcs of general inflammation of the 
bowels. Perforation of the intestines is followed 
by symptoms of surgical shock. It is impos- 
sible for the most skilled diagnostician to dis- 
tinguish this disease in some instances. 

Cause. Usually fecal concretions, fruit pits 
or seeds imprisoned in the appendix ; and con- 
stipation and overeating seem to bring on an 
attack. 

Treatment. Whenever there is a suspicion 
of appendicitis, the patient must remain quietly 
in bed, an ice bag be kept over the region of the 
appendix, large doses of olive oil repeatedly 
administered, inducing frequently loose stools, 
and opiates given sufficient to soothe' pain. 
Under this treatment the majority of attacks 
recover without surgical interference, but 
where perforation is imminent a surgeon 
should remove the offending appendix at once. 
The life of the patient has been saved in a few 
instances where the operation for removal has 
been performed after perforation has taken 
place. This is always a serious malady and a 
physician should be in attendance upon the 
mildest cases. 



CHAPTER II. 

Diseases, whose effects, though extended to the 
whole body, commence in, and are chiefly con- 
fined to, particular parts. 



CEREBROSPINAL MENINGITIS 

BRAIN AND SPINAL FEVER. 

An inflammation of the membranes covering 
the brain and spinal cord. This may be local- 
ized or involve both the cerebral and spinal 
portions. 

Symptoms. Intense pain in the head, — eyes in- 
capable of bearing light, — pupils dilated or con- 
tracted,— restless delirium,— followed by stupor, 
— vomiting, - face flushed,— pulse hard and very 
rapid, — oppression of the chest, — head drawn 
back,— spasms. 

Causes. Exposure to the excessive heat of 
the sun, — blows on the head, — infection of the 
membranes by a specific germ. 

Treatment — Where the disease is suspected, 
the bowels should be opened by administering 
£ of a grain of calomel or one teaspoonful of 
epsom salts every hour until free movements 
occur; an ice bag applied to the head, and a 
physician sent for at once. If much nervous 
irritation is present, liberal doses of bromides 
are good. 

37 



38 Compendium of Domestic Medicine. 



HEADACH. 

Causes. Some particular disease of which it is a 
symptom. Indigestion, — a foul stomach, — tight cra- 
vats or shirt collars, — exposure to the heat of the sun, 
—a rushing of blood into the head. 

Treatment. This will vary according to the 
oause. If it anses from indigestion, that must be 
attended to. A foul stomach is one of the most usual 
causes of headach : such is the connexion between 
these parts, that the one is seldom out of order, with- 
out notice being given of it by the other. In this 
case, an emetic should always be administered, which, 
at a day's interval, is to be followed by a purgative. 
If from the beating of the arteiy in the temples and a 
sense of fulness in the head, we suspect it to originate 
from an undue determination to that part, apply 
ice bladder or cloths dipped in cold water to it. 

Pains in the head frequently originate from old 
venereal complaints. They are also very often 
caused by gout or rheumatism ; for such cases, see 
those complaints. When it arises from acidity of 
the stomach give five or six grs. of bicarbonate of 
potash in dilute camphor water three or four 
times daily. 

See Sick-Headache, post, page 191. 



INFLAMMATION OF THE EYE. 

Symptoms. Pain, heat and swelling of the parte, 
which appear blood-shot, — the tears hot and scalding. 
— fever, — intolerance of light, — sometimes when the 
lids are affected, the edges become ulcerated. 

Causes. External injuries, as blows, — particles of 
sand, &c. getting into them, — exposure to cold, — a 
strong light, — intemperance. 

Treatment. If trie complaint is caused bv fbreigr 



Inflammation of the Eye. 39 

bodies, they must be removed with the point of 
a hair pencil, or the end of a piece of wire cov- 
ered with lint, or washed out by injecting warm 
milk and water into the eye, with a small syringe. 
If particles of iron stick in it, they must be re- 
moved by an oculist. From whatever circum- 
stance it may originate, the inflammation is to 
be subdued by ice or cold applications, and bleed- 
ing from the neighborhood of the eye, by a dozen 
or more leeches. The bowels should be freely 
opened with Epsom salts, and a cold-water poul- 
tice, enclosed in a piece of thin gauze, be laid 
over the part. The room should be perfectly 
dark, and the diet extremely low. Any of the 
lotions No. 9, may be used. If the pain is very 
severe, a small quantity of equal parts of bella- 
donna and water may be dropped into the eye. 
If the eye-lids are ulcerated, touch them with the 
white vitriol ointment. Bathing the eye fre- 
quently with clear cold water is a refreshing and 

useful practice.* 

DIMNESS OF SIGHT. 

Symptoms. The patient imagines he sees par- 
ticles of dust, flies, and cobwebs, floating in the 
air, and cannot distinguish clearly any object, 
either near or at a distance. Though the pupil 
sometimes does not contract, the eye is to all ap- 
pearance unchanged. 

Causes. Pressure on the optic nerves, within 
the scull, by tumours, or other causes, or an error 
or defect in the formation of the nerves them- 
selves, — drunkenness, — blows on the head, — apo- 
plexy, — excessive venereal indulgences. 

* The best plan in all affections of the eye, 
whether inflammation, dimness of sight, &c, is 
to consult an oculist, as the least improper treat- 
ment may cause complete loss of sight. 



40 Compendium of Domestic Medicine, 

Treatment. Blisters, issues, or a seton to the 
back of the neck. Electric sparks passed through 
the forehead, and drawn from the eyes, if perse- 
vered in for a considerable time, may prove effec- 
tual. As many causes of this disease are seated 
in the intestines and stomach, a light emetic may 
be first given, and then a succession of purgatives 
for several days or weeks. 



NIGHT BLINDNESS .* 

Symptoms. The sight is perfectly clear and dis- 
tinct during the day, but completely lost at night. 

Causes. Prolonged exposure to extremely 
bright light, — general debility and exhaustion. 

Treatment. The treatment must be directed 
to strengthening the general health by tonics and 
a generous diet ; give quinine, iron, and cod-liver 
oil. At the same time keep in a darkened room, 
going out only when there is no sun, and even 
then with the eyes protected by dark glasses and 
a shade. . 

INFLAMMATION OF THE EAR. 

Symptoms. Pain in the ear, which at last 
either gradually ceases, or matter is discharged 
through the opening. 

Causes. The accumulation of hard wax, — in- 
sects getting into it, — injuries from blows, &c. 

Treatment. A little warm olive oil, with an 
equal part of laudanum, dropped into the ear, and 

* There are many other diseases incident to the 
eyes, but none that can be managed by any but 
an oculist. When, therefore, any alteration in 
the structure of the eye is perceived, no time 
ehonld be lost in having recourse to one. 




CAYITY OF THE TYMPANUM, OSSICULA AUDI- 
TUS, AND THEIR MUSCLES. (Magnified.) 
a a, cavity of the tympanum, b, membrana tympani, or 
rather the osseous circle to which it is attached, c, 
handle of the malleus, resting on the middle of the 
membrana tympani. d, head of the malleus, articu- 
lating with the incus, e, long handle of the malleus, 
passing into the crenoidal fissure (the anterior mus- 
cle of the malleus is attached to it). /, internal mus- 
cle of the malleus, g, anvil. h t lenticular bones, i, 
stapes, k, musculus stapedius. 



Bleeding from the Nose. 41 

retained there by a piece of wool or cotton, will 
frequently procure almost instant relief. If it be 
caused by hard wax, inject warm water or glyce- 
rine to soften it, and then, with care, endeavour 
to extract it, when the oil and laudanum may 
again be employed. In cases of great severity, a 
blister may be applied behind the ear. A tem- 
porary deafness frequently results from this com- 
plaint, and sometimes, when matter is formed, 
the bones of the organ are destroyed and hearing 

is lost for ever.* 

BLEEDING FROM THE NOSE. 
Causes. Fullness of blood, — violent exercise, — 
particular positions of the body, — blows, &c. 

Treatment. Keep the patient erect, or sitting 
with his head thrown a little backwards, take off 
his cravat, unbutton his shirt collar, and expose 
him freely to the cold air ; apply ice or cold vine- 
gar and water to his testicles, and the back of the 
neck. If these are not sufficient, moisten a plug 
of linen with brandy, roll it in powdered alum 
and screw it up the nostril. A piece of cat-gut 
may, also, be passed through the nostril into the 
throat, drawn out at the mouth, and a bit of 
sponge be fastened to it and drawn back again, 
so as to make the sponge block up the posterior 
nostril. In doing this, it is necessary to leave a 
piece of the cat-gut so as to be got hold of, in 
order to withdraw the sponge. It is seldom, how- 
ever, that the first remedies will not answer the 

purpose. 

POLYPUS. 
The nose is subject to two species of this tumour. 
The pear-shaped or pendulous polypus, and a flat- 
us There are many affections of the ear which 
cannot be mentioned ; however, in all cases, it is 
best to apply at once to an aurist. 



42 Compendium of Domestic Medicine, 

tened irregular excrescence, which is extremely pain- 
ful, and is of a cancerous nature. As soon as any 
affection of this kind is suspected, apply to a surgeon. 



CANCER OF THE LIP. 

This kind of cancer always commences in a small 
crack, which, after a while, becomes exquisitely pain- 
ful. If closely examined, this crack is found to be 
seated in a small hard tumour, which soon ulcerates, 
and if not checked, extends the disorder to the throat, 
thereby endangering life. 

Treatment. The knife is the only remedy for this 
as well as every other species of cancer, and no time 
should be lost in resorting to a surgeon. 



MERCURIAL ULCERS IN THE MOUTH. 

Large, dark looking ulcers in the mouth, are a 
common effect of the use of mercury. They may be 
known by the horrid smell of the breath, by the teeth 
being loosened from the gums, and by a coppery taste 
in the mouth. 

Treatment. Omit all mercurial preparations, 
wash the mouth frequently with sage tea or a solu- 
tion of one drachm of chlorate of potash in five 
ounces of water, and taking a table-spoonful of 
the same mixture inwardly three times daily. 



ULCERS AND PIMPLES ON THE TONGUE. 

Small pimples are occasionally found on the tongue, 
which at last form ulcers. Sometimes they are oc- 
casioned by the rough and projecting edge of a bro- 
ken or decayed tooth: when this is the cause, the 



Ulcers on the Tongue, 43 

part must be rounded by a file or the tooth extracted, 
when the sore will heal without further trouble. 
Whitish looking specks, which seem inclined to 
ipread, are also met with on the inside of the cheeks 
and lips. They are easily removed by touching their 
surfaces with burnt alum or borax. 



CANCER OF THE TONGUE. 

Cancer of the tongue commences like that of the 
lip, being a crack or fissure in a small, hard, deep 
seated tumour on the side of the tongue. 

Treatment. No time should be lost in useless 
attempts to cure it by medicines. The only safety 
for the patient is in the knife, and that at an early 
period. 



VENEREAL ULCERS. 

See Syphilis. 



ENLARGEMENT OF THE UVULA. 

The uvula is that little tongue-like appendage lhat 
hangs down from the middle of the fleshy curtain 
which divides the mouth from the throat. It is very 
subject to inflammation, the consequence of which 
is, that it becomes so long that its point touches, and 
sometimes even lies along the tongue, which creates 
considerable uneasiness, and is now and then the 
cause of a constant cough, which finally ends in con- 
sumption. It is commonly called the falling of ths 
palate. 

Treatment. Strong gargles of vinegar and watej 
or a decoction of the black oak bark, or a watei 



44 Compendium of Domestic Medicine. 

Bolution of alum, will frequently cure the complaint 
It happens very frequently, however, that in conse- 
quence of repeated attacks, it becomes permanently 
lengthened, and then the only resource is to cut on 
the end of it If you aro near a physician apply to 
him, if not, the operation is so simple that any man 
of common dexterity can perform it, particularly as 
little or no blood follows the incision. All that is 
requisite, is to seat the patient, seize the part with a 
hook, or a slender pair of pincers, draw it a little for 
ward, and snip off its point with a pair of scissors 



SWELLING OF THE TONSILS. 

The tonsils are two glands situated in the throat 
one on each side, which are very apt to swell Iron, 
inflammation by colds. They sometimes become sc 
large as to threaten suffocation. 

Treatment. In the commencement, this is the 
same as directed for Inflammatory Sore Throat, 
which see. If it does not succeed, apply to a sur- 
geon to take them away. 



TONSILITIS — QUINSY SORE 
THROAT. 

An inflammation of one or both tonsils, which 
may involve uvula and entire fauces. 

Symptoms. Chills, followed by fever,— inside 
of throat and tonsils inflamed,— white or 
yellow spots on tonsils,— hoarseness,— tender- 
ness,— swallowing painful,— darting pains in 
throat. 

Distinguish it by the severe swelling and 
pain from diphtheria by the spots on tonsils 




VERTICAL SECTION OF THE MOUTH 
AND THROAT. 
1. Pendulous palate; 2. Base of the cranium; 3. Phar* 
ynx ; 4. (Esophagus ; 5. Nose ; 6. Tongue ; 7. Salivary 
glands; 8. Lingual bone; 9. Thyroid gland; 10. Tra- 
chea or windpipe. 



Tonsilitis. 45 



being small, and not having a bleeding sur- 
face when removed, — from scarlet fever by 
absence of pronounced eruption. 

Treatment. If bowels are constipated give 
calomel or epsom salts,— tincture of aconite in 
drop doses every one or two hours,— 10 grains 
of salicylate of soda in water every four hours, 
— gargle frequently with No. 35, — ice pellets held 
in throat, — ice bag on neck. Diet need not be 
restricted but patient usually cares to swallow 
nothing but liquids, and it is better to give 
them cold. 



DIPHTHERIA. 

Symptoms. Diphtheria may exist with evi- 
dences so mild that no one is aware of its 
presence, and in many of the cases, which 
terminate fatally, the illness had been regarded 
as too trivial to demand special concern. In 
the beginning there is usually languor, chilli- 
ness, headache and the symptoms of fever. As 
a rule, there is some pain and soreness upon 
swallowing, and the breath is peculiarly 
offensive. Upon examination, the interior of 
the throat will appear red and swollen, and 
generally there is a gray or ashen brown mem- 
brane on the tonsils and uvula. This membrane 
may form on any of the mucus membranes or 
wherever the skin is abraded. 

Cause. The Klebs-Loffler bacillus. 

Distinguish it by having a bacteriologist ex- 
amine the secretions and mucus membrane of 
the throat for the diphtheria bacillus, — the only 
positive method. 

Treatment. While not nearly so fatal among 
adults as with children, this is nevertheless a 



46 Compendium of Domestic Medicine. 

fearful and treacherous disease, and whenever 
its presence is suspected, a physician should 
be summoned as early as possible. Diphtheria 
antitoxin is superior to all other remedial meas- 
ures, and the earlier the physician injects this 
the better; and repeated injections during the 
course of the disease may be necessary. Mem- 
bers of the family who have been exposed, if in- 
jected with this serum, of proper strength, will 
thereby be prevented from having- the disease, 
and become insusceptible to it for several weeks. 
Throughout the course of the attack, the mouth 
is to be washed and the throat gargled with No. 
35, every two to three hours. Calomel is to be 
given in V Q or -J grain doses every hour and dis- 
continued only at times when bowels are too free. 
Plenty of liquids should be drunk, and one table- 
spoonful of the infusion of digitalis taken three 
times daily. If the membrane extends down 
into the windpipe, closing it so that the patient 
cannot breathe, then a tube must be inserted. 
The patient must remain absolutely quiet for 
three or four days after the membrane has dis- 
appeared from the throat, for fatal heart fail- 
ure sometimes results from not observing 
this precaution. Tablespoonful doses of bitter 
wine of iron should be taken three times a day 
for three or four weeks after all symptoms 
have subsided. The strictest quarantine must 
be practiced, and after recovery the sick-room 
must be fumigated and all clothing, utensils 
and bedding either boiled or burned. 



STRICTURES IN THE THROAT 

Symptoms. The first mark of an obstruction or 
stricture in the throat, is a slight difficulty in swal- 




LUNGS AND TRACHEA IN MAN, 

showing the position of the windpipe and bromchial tubes, 
relatively to the lungs. 

A, Larynx and superior extremity of the trachea ; B, 
trachea; C, division into bronchi; D, one of the lungs; 
E, bronchial ramuscules. 



Strictures in the Throat. 47 

iowing solids, which continues increasing for months, 
or until the passage becomes so contracted that the 
smallest particle of food cannot pass, but having re- 
mained an instant at the strictured part, is violently 
rejected. If the obstacle is not removed, the patient 
starves. 

Treatment. Meddle not with the complaint your- 
self, for you can do nothing to relieve it, but apply 
with all speed to a surgeon, and remember that your 
life is at stake. 



CATARRH, OR COLD. 

Symptoms. A dull pain in the head, — swelling 
and redness of the eyes, — effusion of a thin acrid mu- 
cus from the nose, — hoarseness, — cough, — fever, &c. 

Causes. Cold or damp air, — exposure to wet 

Treatment. If the symptoms be extremely vio- 
lent, give twenty drops of hartshorn in half a pint 
of warm vinegar whey. (See No.l2.)Hoarhound and 
boneset tea taken in large quantities, are very useful. 
The patient should be confined to his bed, and be 
freely purged. If there is great pain in the breast, 
apply a blister to it To ease the cough, take two 
tea spoonsful of No. 13, every fifteen minutes, or till 
relief is obtained. 

The influenza is nothing more than an aggra- 
vated state of catarrh, and is to be cured by the same 
remedies. No cough or cold is too light to merit at- 
tention. Neglected colds lay the foundation of con 
tumption, and every year send thousands to the grave. 



ASTHMA 

Symptoms. A tightness across the breast, — fre- 
quent short breathing, attended with a wheezing, in- 



48 Compendium of Domestic Medicine. 

creased by exertion and when in bed. It comes 
on in fits or paroxysms. 

Causes. Spasm of the lungs. 

Treatment. If the cough be violent and fre- 
quent, with great pain in the breast, breathe the 
smoke from burning paper saturated with salt- 
petre, or the fumes of burning dried stramonium 
leaves. The tincture of digitalis is highly recom- 
mended in asthma. It should be taken in doses 
of a very few drops at first, and cautiously in- 
creased. If the pulse sinks under it, or giddi- 
ness, &o. is produced, it must be laid aside. In 
fact, it is hardly prudent to take this active and 
dangerous article, except under a physician's 
care. The Indian tobacco may be safely used in 
place of it, in doses of a tea-spoonful of the tinc- 
ture,* every half hour till relief is obtained. 
The dried roots of the thorn apple and skunk 
cabbage, are sometimes smoked through a pipe 
for the same purpose. Asthma is a disease that 
is seldom completely cured by art ; nature, how- 
ever, occasionally affects it. 



PLEURISY. 

Symptoms. A sharp pain, or stitch in tne side, 
increased upon breathing, — inability of lying on 
the affected side, — pulse hard, quick and corded, 
— tongue white. 

Causes. Cold— all that produce inflammation. 

Treatment. Apply at once 6 or 8 wet cups, or 
place a large blister over the side and give a full 
dose of Epsom salts. Repeat the cupping as often 
as the pulse seems to demand it, and if expec- 

* Take a sufficient quantity of the leaves, stem 
and pods of the plant, put them into a bottle and 
fill it up with brandy or spirits, and let it remain 
for a few days. 



Pleurisy. 49 

(oration does not come on, apply another blister close 
to the first one. All the remedies for the reduction 
of inflammation, must be actively employed. The 
patient should be confined to his bed, with the head 
and shoulders a little elevated, and a warm decoc- 
tion of the common hemlock* taken frequently, and 
in liberal quantities. The diet should always consist 
of rice or barley water. 



SPITTING OF BLOOD. 

Symptoms. Blood of a bright red colour, often 
frothy, brought up by coughing. 

Causes. Consumption and its causes, — a fullness 
of blood, — rupture of a blood vessel from any cause. 

Distinguish it from vomiting of blood, by its bright 
colour, and being Drought up with coughing. 

Treatment. Give the patient at once a table 
spoonful of common salt, and direct him to swallow 
it. Apply cold to the chest. The sugar of lead 
has much reputation in this complaint; 2 or 3 
grains of it, with from a half to a whole grain of 
opium, may be taken every 3 or 4 hours ; and in se- 
vere cases, where the blood flows rapidly, 5 or 6 
grains, with two of opium, may be taken at once. 
The most perfect rest should be strictly enjoined 
and the diet consist of cold mashed turnips or cola 
rice water. 



CONSUMPTION. 

Symptoms. A short, dry cough, — languor and 
gradual loss of strength, — pulse small, quick, and 
soft, — pain in the breast, — expectoration of a frothy 

* Twigs and leaves of the tree. 
D 



50 Compendiuri of Domestic Medicine. 

matter, that at last becomes solid and yellow, — the 
breathing grows more anxious and hurried. — the 
emaciation and pain increase, — hectic fever. — night 
sweats and a looseness of the bowels come on, and 
the patient, unsuspicious of danger, dies. 

Causes. Receiving a disposition to the disease 
from father or mother, — a flat chest, — spitting of blood, 
— neglected colds,— dissipation, &c. 

Distinguish it by the long continued dry cough, 
— pain in the breast, and great emaciation, — by the 
matter thrown up being pure pus. 

Treatment. In a confirmed state of consumption, 
nothing that art has hitherto been able to do, can 
anord us any solid hopes of a cure. When once the 
disease is firmly seated in the lungs, all that is possi- 
ble, is to smooth the passage to the grave, and per- 
haps for a while to retard it If, however, the dis- 
ease is taken in its very bud, much may be done by 
a change of climate, a milk diet, vigorous and daily 
exercise on horseback, and by carefully avoiding cold 
and all exciting causes. A removal to a dry cli- 
mate should be the first step taken, if practicable j 
a cold, dry climate is better than a warm, moist 
one. A complete suit of flannel, worn next the 
skin, is an indispensable article for every one who 
is even inclined to this most fatal disorder. 



PALPITATION OF THE HEART. 

The symptoms of this complaint must be obvious 
from its name. When it arises from a diseased state 
of the heart or its vessels, nothing can be done to cure 
it. The patient should be careful to avoid a full 
habit of body, and abstain from violent exercise and 
sexual indulgences. He should live low, and keep 
as quiet and composed as possible. A fit of anger, or 
any imprudence, may cost him his life. 

There is a milder kind of this disease resulting 




THE HEART, (right side.) 



Palpitation of the Heai t. 51 

from debility, which must be remedied by restoring 
the strength of the general system. It is also symp- 
tomatic of other diseases, and must be treated ac- 
cordingly. 



DROPSY OF THE CHEST. 

Symptoms. Great difficulty of breathing, which 
is increased by lying down, — oppression and weight 
at the breast, — countenance pale or livid, and ex- 
tremely anxious, — great thirst, — pulse irregular and 
intermitting, — cough, — violent palpitation of the 
heart, — the patient can lie on one side only or cannot 
lie down at all, so that he is obliged to sleep sitting, 
—frightful dreams, — a feeling of suffocation, &c. 

Causes. Debility, — all those producing dropsy in 
general. 

Distinguish it by comparing carefully all the 
symptoms together. It is most liable to be confounded 
with a diseased state of the heart and its vessels. 

Treatment. This is another of those diseases that 
mock the art of man. To say it is incurable, would 
be hazarding too much, but as vet, it has nearly al- 
ways proved so. All that can be done is to follow 
the same plan that is laid down for the treatment of 
dropsy in general, which consists of purging, dia- 
phoretics and diuretics.* When the water ap- 
pears to be confined to one cavity of the chest, and 
the oppression cannot be borne, some relief may 
be obtained by a surgical operation. 



* Substances that act on the kidneys, producing as 
increase of urine. 



52 Compendium of Domestic Medicine, 

INFLAMMATION OF THE STOMACH 

Symptoms. A fixed burning pain in the stomach, 
— smaVl, very quick, hard pulse, — sudden and great 
weakness,— "the pain in the stomach increased on the 
slightest pressure, — vomiting, — hiccup. To these are 
sometimes added an erysipelatous inflammation, ex- 
tending from the mouth to the stomach, — fainting, 
clammy sweats, and death. 

Causes. Cold suddenly applied to the body or 
stomach, — drinking largely of cold water while very 
warm, — the striking in of eruptions, — poisons, — gout, 
— rheumatism. 

Distinguish it from inflammation of the bowels, by 
the seat of the pain, which is just below the breast 
bone, in what is called the pit of the stomach, rhe 
burning heat and pain there, — by the hiccup and 
vomiting. 

Treatment. If from an overloaded stomach, 
or indigestible food therein, give an emetic ; but 
if by examination it is found that the food has 
passed out of the stomach into the intestines, give 
no emetic, but a purge of senna leaves with mag- 
nesia. A day or two afterward, to remove the 
acidity of the stomach, give 6 to 10 grs. of bicar- 
bonate of soda or soda water. If, however, the 
inflammation is from general debility, give no 
emetic or purgative, but beef tea, wine, quinine, 
&c, and place warm emollient poultices on the 
stomach. If from cold, give no meat, but farina- 
ceous diet; 6 to 10 grs. of bicarbonate of soda 3 
or 4 times daily, and keep the bowels open with 
calcined magnesia and senna. Use no spirituous 
liquors, but drink freely of ice water. If there is 
much pain, give besides the warm poultice in- 
wardly neutral mixture, with sulphate of morphia 
every 1 or 2 hours. 

When the inflammation is reduced, and the sto- 
mach will bear it, a grain of solid opium may be 



« Til Tr/MfAfM^,.. "tehS^^*""ii ii 1 



2 H\l// 




CAVITY OF THE ABDOMEN. 



1. Diaphragm. 

2. Gall-bladder. 

3. Right lobe of liver. 

4. Duodenum. 

5. Great end of stomach. 

6. Pyloric end of stomach. 

7. Spleen. 



8. Omentum. 

9. Pancreas. 

10. Great intestine, (colon.) 

11. Small intestine, 

(jejunum.) 

12. Small intestine, 

(ilium.) 



Inflammation of the Stomach. 53 

given occasionally with advantage, combined with 
some bitter tonic, as tincture of cardui benedicti, 
extract of absynthi. If the disease has been 
brought on by poison taken into the stomach, apply 
the remedies directed in such cases, as oleaginous 
substances, to neutralize the poison ; if, however, 
there is beginning paralysis, give an emetic and 
put sinapisms on the stomach. If mortification 
ensues, death is the inevitable consequence. 



CRAxMP IN THE STOMACH. 

Symptoms. Violent spasmodic pain in the stomach, 
which is so severe, as nearly to occasion fainting. 

Causes. Cold, — gout, — rheumatism, &c. &c. 
* Treatment. Give 50 or 60 drops of laudanum, 
in a tea spoonful of etherr, with a little hot wine. 
Apply bladders or bottles filled with warm water to 
the stomach and soles of the feet, or put the patient 
into the warm bath. If the first dose of laudanum 
does not relieve the pain, repeat it. 



HICCOUGH. 

Symptoms. A spasmodic affection of the stomach 
and diaphragm,* producing the peculiar noise which 
gives rise to the name. 

Causes. Some peculiar irritation. 

Treatment. When hiccoughs occur at the close 
of any disease, they may be considered the harbin- 
gers of death : they, however, frequently arise from 
acidity in the stomach and other causes. A long 

* A large, broad muscle that closes the chest be- 
low, dividing it from the belly. It is one of the 
agents in respiration. 



54 Compendium of Domestic Medicine. 

draught of cold water, a sudden surprise or fright, 
puts an end to them. A blister over the stomach 
may be applied for the same purpose. I have 
succeeded in relieving a violent case of hiccoughs 
that resisted every other remedy, by the oil of 
amber, in doses of five drops every 10 minutes. 
It may be taken in a little mint water. 



HEART-BURN. 

This common and distressing affection is most ge 
nerally connected with indigestion. To relieve it 
for the moment, magnesia, soda or seltzer water, and 
water acidulated with sulphuric acid, may be em- 
ployed. To cure the complaint, requires the diges- 
tive powers to be strengthened by tonics, bitters, and 
the different preparations of iron, &c. as directed for 
indigestion. The application of a blister over the 
stomach may be of use. The white oxide of bismuth 
in six grain doses, three times a day, taken in milk, 
has been found of service. 



INDIGESTION. 

S v mptoms. Want of appetite, — low spirits, — pains 
and fullness in the stomach, — belching, — a sour water 
rising in the mouth, — heart-burn, — the bowels are 
irregular and generally costive, — weakness and ema- 
ciation, — pulse small and slow, — pain in the head, — 
gkin dry, — great uneasiness after eating. 

Causes. All those which induce debility, — ex- 
cessive indulgence in the pleasures of the table or 
intemperance in any way, — chewing tobacco, — a 
sedentary life, or want of exercise, — a diseased liver. 

Treatment. In every case of indigestion, the first 
thing the patient should do, is to abstain from what- 



Indigestion. 55 



ever may have tended to produce it. Chewing and 
smoking tobacco, occasion a waste of the saliva that 
is necessary to the digestive process — they must be 
abandoned. The diet should consist of animal food 
that is light, nourishing and easily digested. Roasted 
mutton is perhaps preferable to any other. Country 
air and constant exercise on horseback, are invalua- 
ble remedies in this disease, which, as it is generally 
occasioned by a departure from natural habits and 
employments, must be relieved by a return to them. 
Flannel should be worn next the skin and care taken 
to avoid cold or exposure to wet A wine glass of 
the cold infusion of bark and quassia,* with ten or 
twelve drops of the elixir of vitriol, should be regu- 
larly taken three times a day, for months. The 
bowels are to be kept open by some warm laxative, 
as rhubarb, and the whole frame braced by the daily 
use of the cold bath. Pepsin in ten to fifteen gr. 
doses with bismuth just before meals is of much 
use in the complaint of which we are speaking. 
Weak spirits and water, or a single glass of sound old 
Madeira, maybe taken at dinner, but all malt liquors 
should be avoided. Much benefit has been found to 
result from a long continued use of the wine of iron,+ 
a glass of which may be taken twice a day. 

But see post, page 174, for a much fuller account 
of Indigestion, or Dyspepsia. 



* Made by placing one ounce of powdered bark 
and one of ground quassia in a close vessel, to which 
is added a quart of boiling water — to be kept simmer- 
ing near the fire until the whole is reduced to a pint 

t Take of iron filings four ounces, and pour on it 
four pints of Madeira wine, let it stand for a month, 
shaking it frequently. 



56 Compendium of Domestic Medicine. 

VOMITING OF BLOOD. 

Symptoms. A flow of dark blood from the stomach, 
preceded by a sense of weight and oppression in that 
organ. The blood is generally mixed with particles 
of food, &c. 

C a uses. Tumours pressing on the liver, blows, &c 

Distinguish it from spitting of blood, by its dark 
colour and being mixed with food. 

Treatment. If the accompanying symptoms be 
inflammatory, use some cooling purge : if other- 
wise, try thirty drops of the muriated tincture 
of iron in a glass of water, every hour till the bleed- 
ing ceases. If the cause be a diseased liver, or tumour 
in its neighbourhood, treat it accordingly. 



INFLAMMATION OF THE LIVER. 

Symptoms. A dull pain in the right side below the 
rib, which is more sensible on pressure, — an inability 
to lie on the left side, — pain in the right shoulder,* — 
a sallow complexion. Such are the symptoms of an 
acute attack of this disease. There is another species 
jf it, called chronic, in which its approaches are so 
gradual that it is a difficult matter to determine its 
nature. It commences with all the symptoms of in- 
digestion, and ends in jaundice or dropsy. 

Causes. Long continued fe ver and ague, — inflam 
mation, — acrid bile, — drunkenness or a free use of 
spirituous liquors is a very common cause, — injuries 
from blows, &c. 

Distinguish it from pleurisy, by the pain not be- 
ing so severe ; and by its extending to the top of the 
shoulder, — by not being able to rest on the left side. 

Treatment. If from injury, apply leeches, and 

* This is owing to the course of the phrenic nerve. 




THE LIVER. 



A, right lobe. B, left lobe, a, depression for colon, b, 
depression for right kidney and capsule, cc, coronary 
ligament, inferior layer, dd, surface uncovered by 
peritoneum, e, gall-bladder. //, fissure for gall-blad- 
der, g g, transverse fissure. /?, lobulus quadratus. i, 
umbilical rein. 7,7iepatic duct, k, hepatic artery. I, 
ductus venosus. m m, fissure for ductus venosus. n, 
vena portae. o, lobulus caudatus. p, lobulus Spigelii. 
q, inferior vena cava, r, fissure for inferior vena cava, 
5 s, longitudinal fissure. 



Inflammation of the Liver. 57 

afterward ice over the part. If from other causes, 
warm emollient and narcotic poultices are better, 
and antiphlogistics and calomel are dangerous, 
The bowels should be opened by Epsom salts or 
calomel and jalap. If this does not abate the symp- 
toms in a few days, give a calomel pill of one grain 
every five hours, or rub a drachm of the strongest 
mercurial ointment into the side until the gums are 
found to be a little sore, when the frictions or pills 
must be discontinued until the mouth is well, and 
then again resorted to as before. If an abscess points 
outwardly, apply bread and milk poultices to the 
tumour, omit the mercury, use wine, bark and a ge 
nerous diet. As soon as matter is to be felt within 
it, open it at its lowest and most projecting part with 
the point of a sharp lancet, and let out its contents 
very slowly, taking care not to close the wound till 
this is completely effected. The nitric acid in doses 
of ten or twelve drops, three times a day, gradually 
increased, and steadily persevered in, will sometimes 
produce a cure. The mercurial plan, however, is to 
be preferred. 



JAUNDICE. 

Symptoms. Languor, — loathing of food, — a bitter 
taste in the mouth, — vomiting, — the skin and eyes of 
a yellow colour, — the stools clayey, and the urine giv- 
ing a yellow tinge to rags dipped in it. There is a 
dull pain in the right side, under the last rib, which 
is increased by pressure. When the pain is severe, 
there is fever, — the pulse hard and full, &c. 

Causes. An interruption to the regular passage 
of the bile, which is carried into the blood, — bile be- 
ing formed in too great quantities. The first is occa- 
sioned by gall-stones, a diseased liver, &c. Intem- 
perance is a very common cause, hence tipplers are 
more subject to it than others. 



58 Compendium of Domestic Medicine. 

Treatment. Place in a warm bath, and allow 
to remain there some timt ; when removed to bed, 
a grain or two of opium may be given every few 
hours until the pain is relieved. Bladders partly 
filled with warm water, or cloths wrung out of hot 
decoctions of herbs, may also be applied to the seat 
of the pain. If the stomach be so irritable as not 
to retain any thing on it, try fomentations and the 
effervescing mixture, or a blister to the part. As 
soon as some degree of ease is obtained* by these 
means, purgatives must be omployed, and steadily 
persevered in; calomel and jalap, or Epsom salts, 
in the ordinary doses, answer very well. The diet 
ought to be vegetable, and should the disease 
have arisen from a neglected inflammation of the 
liver, it must be treated accordingly. Diaphoretics 
and resolvents should be given to remove the bile 
from the blood and tho discoloration of the skin ; 
for which acetate and muriate of ammonia,rhubarb, 
dandelion root, andchelidonium are recommended. 
Turpentine is particularly good if there be gall- 
stones or hardening of the liver. (See Inflam- 
mation of the Liver.) If putrid symptoms show them- 
selves, meet them with the remedies already directed 
for such cases. Regular exercise (on horseback, if 
possible) should never be neglected by persons sub- 
ject to this disease. 



* If, however, this cannot be done, and from the 
pain being very acute at one particular spot, there is 
reason to suppose that a gall-stone is lodged there, the 
following remedy may be tried, of which one-fifth or 
a little less may be taken every morning, drinking 
freely of chicken broth, flaxseed tea, or barley water 
after it. 

Ether three drachms. 

Spirits of turpentine two drachms. Mix them 



Ague Cake. 59 

AGUE CAKE. 
Ihis is the vulgar appellation of an enlarged 
sp'een, and expresses with much brief meaning, 
th 9 cause of the complaint, as it generally results 
fr< m ill-treated or obstinate intermittents. It is, 
however, not productive of much uneasiness, and 
frequently disappears of itself. The plan of 
tr *atment must be governed by the cause : by in- 
t( nnittents, quinine ; by chlorosis, iron with qui- 
cine; by anaemia, quinine with sulphur, auratum, 
iodide of iron; by syphilis, mercury, &c. 



INFLAMMATION OF THE INTESTINES. 

Symptoms. Sharp pain in the bowels which 
shoots round the navel, and which is increased by 
pressure, — sudden loss of strength, — vomiting of 
dark coloured, sometimes excrementitious mat- 
ter, — costiveness, — small, quick and hard pulse, — 
high coloured urine. 

Causes. Strangulated ruptures, — cold, — accu- 
mulations of hard feces in the bowels, — colic, &o. 

Distinguish it from colic, by the pain being 
increased by pressure, whereas in colic it is re- 
lieved by it. 

Treatment. Consists in warm narcotic appli- 
cations to the abdomen; olive oil and laudanum 
on a thick piece of flannel applied very warm 
is good ; warm baths, oleaginous drinks and 
emulsions, as oil of sweet almonds with gum 
arabic ; strict diet, ipecacuanha and opium in 
powder, £ gr. each, every 1 or 2 hours, — calomel 
and opium, castor oil, <fcc. If there is sweating; 
then warm baths are contraindicated. 



60 Compendium of Domestic Medicine 

The diet should consist of small quantified of 
barley or rice water only. If in the latter Sv.xges 
of the disease, when the inflammation has 8 me- 
what subsided, an obstinate costiveness be found 
to resist all the usual remedies, dashing cold watet 
over the abdomen will sometimes succeed, or better 
still to place ice in a bladder over the abdomen. 

Remember that this complaint frequently runs its 
course in a day or two, and that, unless the proper 
treatment be at once employed, mortification and 
death will ensue. If a strangulated rupture occa- 
sion the disease, attempts at reduction must be 
tried, or operation at once. Great care must be 
taken in trying to reduce the rupture if it be the 
cause. It is best to call a physician. 



CHOLERA MORBUS, OR VOMITING AND 
PURGING. 

Symptoms. A violent vomiting and purging of 
bile, preceded by a pain in the stomach and bowels, 
— quick, weak and fluttering pulse, — heat, — thirst, - 
cold sweats, — hiccups, and sometimes death in a few 
hours. 

Causes. Exposure to sudden changes of weather, 
— not wearing flannel, — unripe fruit, — acrid matters 
of any kind in the bowels, — cold moist air, &c. 

Treatment. Wash out the stomach and bowels 
with copious draughts of chamomile tea, barley or 
chicken water, &c. and inject clysters of the same 



Cholera Morbus. 61 



articles. Bladders or bottles containing hot water, 
should be applied to the feet, and flannel cloths 
wrung out of hot spirits, be laid over the stomach. 
When from the quantity of barley wa'er, <fec. that 
has been taken, it is supposed that the stomach is 
sufficiently cleared, give one-half grain of powdered 
opium, and repeat it every few hours as the case 
may require.* If the powder will not remain in 
the stomach, give 80 or 90 drops of laudanum, in 
a table-spoonful of thin starch, by clyster, and 
pieces of ice on the tongue. Fifty or sixty drops 
of laudanum in a small quantity of strong mint tea, 
or the effervescing draught, will frequently succeed 
in allaying the irritation. If all these means fail, 
apply a blister to the stomach. When the violence 
of the attack is over, give castor oil or the oil mix- 
ture, No. 14, to carry off the bile that may remain in 
the bowels. To complete the recovery and to guard 
against a second attack, a complete casing of flannel is 
requisite, with the use of vegetable bitters and tonics. 
Persons subject to this disease should be cautious in 
their diet, and avoid exposure to moist cold air. 
See Asiatic, or Epidemic Cholera, post, p. 163. 



DYSENTERY. 

S ym ptoms. Fever, — frequent small stools, accom 
panied by griping, bearing down pains, the discharge 
consisting of pure blood or blood and matter, some- 
times resembling the shreds or washings of raw flesh, 
— a constant desire to go to stool, — vomiting. 

Causes. Moist cold air, — unwholesome, putrid 

* If the weakness be very great, and the spasms 
so alarming as to cause a fear of the immediate re- 
suit, the quantity of opium may be increased to 6, 8 
or 10 grains at a dose. 



62 Compendium of Domestic Medicine. 

food, — noxious vapours from marshes, &c, — a 
peculiar and unknown condition of the atmos- 
phere. 

Distinguish it from a diarrhoea or lax, by the 
fever, griping pains, and the constant desire to 
evacuate the bowels, — by the discharge itself 
being blood, or matter streaked with blood, &c. 

Treatment.* In case the dysentery should be 
caused by hardened feces or something in the 
intestines, give at the first onset of the disease a 
dose of castor oil with 20 drops of laudanum, and 
then the following day begin the remedies to cor- 
rect the looseness of the bowels. If there is 
blood diarrhoea, colic pain and tenesmus, give 
Dover's powder or an emulsion of oil of sweet 
almonds, nitrate of soda with laudanum. Make 
warm fomentations on the abdomen. If this does 
not cure, give every 2 hours small doses of calo- 
mel and opium, and in the evening 5 or 10 grains 
of Dover's powder, — and morning and evening a 
clyster of nitrate of silver, 2 gr. to 5 oz. water, 
with 10 drops of laudanum therein. The diet 
should consist of gum arabic dissolved in milk, 
arrow-root jelly, barley water, &c. Clysters of 
the same articles, with the addition, of an ounce 
of olive oil, and twenty drops of laudanum, may 
be likewise injected several times in the day. — 
If severe tenesmus (or constant desire to go 



* I have known several cases of dysentery, 
when taken in the very beginning, cured in one 
or two days by a free use of the common black- 
berry syrup. 



Dysentery. 63 



to stool) remains, anodyne clysters will be found use- 
ful, or what is more effectual, a couple of grams of 
opium placed just within the fundament The vari- 
ous astringents which are proper for dysentery in its 
latter stages, are found in Nos. 15, 16, and 17, which 
may be used with port wine and water, as a drink. 



DIARRHEA. 

Symptoms. Repeated and large discharges of a 
thin excrementitious matter by stool, attended with 
griping and a rumbling noise in the bowels. 

Causes. Cold, — suppressed perspiration, — acrid 
matters in the bowels, — unripe fruit, &c. 

-Treatment. If the disease arises from cold, a 
few doses of the chalk mixture, No. 18, will fre- 
quently put an end to it It is, however, sometimes 
necessary to begin with an emetic of twenty grains 
of ipecacuanha, and then open the bowels by some 
mild purgative, as castor oil or rhubarb. Bathing 
the feet in warm water, and copious draughts of 
boneset tea, will be found of great benefit, if it ori- 
ginate from suppressed perspiration. For the same 
purpose also, from 6 to 10 grains of Dover's powder 
may be taken at night, being careful not to drink any 
tiling for some time after it If worms are the cause, 
treat it as directed. When it is occasioned by mere 
weakness, and in the latter stages of it (proceed from 
what it may), when every irritating matter is expell- 
ed, opium, combined with astringents, is necessary, as 
in the similar period of dysentery. The diet should 
consist, in the beginning, of rice, milk, sago, &c. and 
subsequently of roasted chicken. Weak brandy and 
water, or port wine and water, may accompany the 
chicken for a common drink. Persons subject to 
complaints of this kind, should defend their bowels 
from the action of cold by a flannel shirt ; the feet and 
other parts of the body should also be kept warm. 



64 Compendium of Domestic Medicine. 



COLIC. 

S ymptoms. Violent shooting pain that twists round 
the navel, — the skin of the belly drawn into round 
balls, — obstinate costiveness, — sometimes a vomiting 
of excrement. 

Causes. A cold, — indigestible or acrid food, — 
wind in the bowels, — poisons, — gout, — rheumatism, 
— worms, &c. &c. 

Distinguish it from inflammation of the bowels by 
the pain being relieved by pressure, and from other 
diseases by the twisting round the navel, — the skin 
being drawn into balls, &c. 

Treatment The first thing to be done in this 
disease, is to give a large dose of laudanum in a little 
peppermint water or warm brandy, and apply a 
mustard poultice below the navel. Fifty, sixty or 
seventy drops of laudanum may be given at once, 
as the pain is more or less violent, and the dose 
be repeated in half an hour, or less time, if ease is 
not procured, while some warm fomentations on the 
abdomen will afford much relief; when this does 
not help, try ice. During this time, if the first 
doses of laudanum are found ineffectual in re- 
ducing the pain, and it is very great, eighty or ninety 
drops may be given as a clyster in a gill of gruel, or 
warm water. One great rule in the treatment of 
colic where the pain is excessive, is, to continue the 
use of opium in such increased doses as will relieve 
U ! — When this is obtained, castor oil by the mouth 
and clyster must be employed to open the bowels. 

In bilious colic when there is a vomiting of bile, 
the effervescing draught, with thirty drops of lauda- 
num, may be taken, to quiet the stomach, to which 
flannels wrung out of warm spirits may be applied. 
When the vomiting has abated, the oil mature. No 



Colic. 65 

14, or the pills, No 19, should be taken until a free 
discharge is procured. If, notwithstanding our en- 
deavours, the disease proceeds to such an extent as 
to induce a vomiting of excrement, the tobacco clys- 
ter* must be tried, or an attempt be made to fill the 
intestines with warm water. This is done by forci bly 
injecting it in large quantities, at the same time the 
patient swallows as much as he is able. In this 
way, with a proper syringe, two gallons have been 
successfully introduced. In all cases of colic, when 
there is obstinate costiveness, an examination of the 
fundament should be made with the finger If there 
are any hard, dry pieces of excrement there, they 
may be removed either by the finger or the handle 
of a spoon. 

Those who are subject to colic, should avoid fer- 
mented liquors, and as much as possible, vegetable 
food ; be always well clothed, and take care not to 
expose themselves to cold and wet. The bow r el* 
should never be allowed to remain costive. 



PAINTER'S COLIC. 

Symptoms. Pain and weight in the belly, — belch- 
ing, — constant desire to go to stool, which is inef- 
fectual, — quick contracted pulse, — the belly becomes 
painful to the touch, and is drawn into knots, — con- 
stant colic pains, — the patient sits in a bent position, 
— after a while palsy of the whole body or a part. 

Causes. The fumes of lead, or the handling of 
its different preparations. 

Treatment. This disease is but too apt to end a\ 
palsy, leaving the hands and limbs contracted and 
useless. In every case of colic, whose symptoms 
reserible the above, if the person has been exposed 

* See Clysters. 



66 Compendium of Domestic Medicine. 

to lead in any of its shapes, all doubt on the sub- 
ject vanishes. 

If from the violence of the attack an inflamma- 
tion of the bowels be feared, give hourly a table 
spoonful of castor oil. Give laudanum in large 
doses, and rub the belly well with warm spirits, 
and place him in a bath as hot as he can bear it. 
As soon as he is well dried, and has rested in bed 
a few minutes, take him up, and dash a bucket 
of cold water over his belly and thighs, or mix 
an ounce of calcined magnesia in a pint of milk, 
and give a wine-glassful every half hour, until 
ease is obtained. If this, with castor oil by the 
mouth and in clysters, will not produce a stool, 
apply a large blister to the belly. As soon as the 
symptoms are somewhat abated, castor oil or 
laxative clysters may be resorted to for the pur- 
pose of keeping the body open; and to guard 
against a return, small doses of opium should be 
taken from time to time. Bitters, the different 
preparations of iron, bark, &c. are necessary to 
restore the strength of the system. According to 
modern times, let those who work in lead or paint, 
drink of skimmed milk with their meals, and 
lead or painter's colic will be warded off. 



WORMS. 

Symptoms. Intolerable itching at the nose, some- 
times at the fundament, — disagreeable breath, — 
grinding of the teeth and starting during sleep, 
— hardness of the belly, — gradual emaciation, — 
. colic, and sometimes convulsions. 

Causes. Unknown. 

Treatment. This will vary according to the 
kind of worm that is to be destroyed. They are 
of three kinds : 



Worms. 67 

THE WHITE THREAD WORM 

Resembles a small piece of white thread, and is 
usually found near the fundament, at the lower end 
of the guts, where it produces a contraction of the 
parts, and a most intolerable itching. Clysters of 
lime water will frequently bring whole nests of them 
away, and procure instant relief. The tincture of 
aloes, No. 20, how T ever, is by far the best remedy 
known, for not only this, but the round worm. 

THE ROUND WORM 

Occupies the small intestines, and sometimes the 
stomach. It is of various lengths, from 3 to 8 or 
more inches. If the tincture of aloes fail to remove 
it, the pink root may be taken in decoction, or in 
powder, in doses of 60 or 80 grains, to be followed 
after three or four days by ten or fifteen grains of 
calomel. Cowhage in molasses or honey, with a 
dose of castor oil every third day, has been very 
highly extolled. In cases where all other means 
have failed, tobacco leaves pounded with vinegar 
and applied to the belly, have produced the desired 
effect.* 

THE TAPE WORM 

Inhabits the whole of the internal canal, and fre- 
quently defies all our efforts to get him out of it 
Large doses of spirits of turpentine, from one to two 
ounces, in barley water, have been advantageously 
employed for this purpose, and are the very surest 
remedy that we possess. A remedy formerly much 
celebrated, is that of Madam Noumer, the basis of 
which is No. 21 ; after two doses of which, 15 or 20 
grains of jalap with 8 or 10 of calomel should be 
taken. If the spirits of turpentine be tried, large 



cession. 



All the prescriptions, No. 22, maybe tried in suc- 
tion. 



68 Compendium of Domestic Medicine. 

quantities of gruel or barley water should be used 
with it, in order to prevent its irritating the stomach 
and kidneys. 

By whatever means these troublesome guests are 
got rid of, the patient should be careful to strengthen 
his system and bowels by a course of bark, bitters, 
wine, &c. and to use a great proportion of animal 
food in his diet. 



INFLAMMATION OF THE KIDNEYS. 

Symptoms. Deep seated pain in the small of the 
back, — urine high coloured and small in quantity, 
sometimes bloody, — sickness at the stomach, — vomit- 
ing. 

Causes. Gravel in the kidneys, — Spanish flies, — 
straining the back, — hard exercise by riding, walk- 
ing, &c. — cold, — intemperance. 

Treatment. This will depend upon the cause. 
If it proceed from gravel, the plan to be pursued will 
be detailed under that head. If it arise from any of 
the others, place warm emollient narcotic fomen- 
tations over the region of the kidneys, or put 
him into a warm bath. Twenty grains or more 
of the uva-ursi, with half a grain of opium 
three times a day, accompanied by small quanti- 
ties of warm barley or rice water, is one of the 
most valuable remedies we are in possession of. 
The diet during the attack should consist of muci- 
laginous drinks only, which must be frequently 
taken, notwithstanding they may be rejected by 
vomiting. 



GRAVEL. 

Symptoms. A fixed pain in the loins, — numbnesa 
of the thigh, — constant vomiting, — retraction of the 




VERTICAL SECTION OF THE KIDNEY. 

3, supra-renal capsule, b b, cortical substance of kid- 
ney, c c, medullary substance of kidney, e e e, the 
sinus or pelvis. /, the ureter, proceeding to tht 
bladder. 



Grai el. 69 

testicle, — urine small in quantity, voided with pain, 
and sometimes bloody. As the gravel passes from 
the kidney into the bladder the pain is so acute as to 
occasion fainting, &c. &c. 

Causes. The formation of a peculiar acid in the 
kidneys. 

Treatment. Chloroform inhalation, or put him 
into a warm bath, where he should remain some 
time. Meanwhile an emollient and anodyne clyster 
should be got ready, which must be given to him as 
soon as he leaves it. Cloths wrung out of decoctions 
of herbs or warm spirits and water, should be ap- 
plied to the part, and small quantities of warm gum 
arabic tea or barley water be taken frequently. 
A grain of opium every two hours, will be found 
useful. Strong coffee, without sugar or cream, some- 
times acts like a charm in soothing the pain: tw T enty 
drops of the spirits of turpentine taken on a lump of 
sugar every half hour, is said, by high authority, to 
do the same. If the irritation of the stomach is very 
great, the effervescing draught, with 30 or 40 drops 
of laudanum, may be tried. When ihe pain, &c. is 
somewhat abated, the bow r els should be opened, either 
with castor oil or Epsom salts. The uva-ursi, as be- 
fore mentioned, is one of the most valuable, remedies 
in all diseases of the kidneys that we have. Blisters 
in all such cases are never to be applied. Persons sub- 
ject to this distressing complaint, should be careful to 
avoid acids and fermented liquors of all kinds, in- 
cluding the red wines, beer, pickles, &c. For a com- 
mon drink, soft-water, or the seltzer and soda waters 
are to be preferred. When any threatening symp- 
toms are perceived, recourse should be had to the 
uva-ursi, in small doses of ten or twelve grains, with 
half a grain of opium three times a day, to be c an- 
♦inued for weeks. 



70 Compendium of Domestic Medicine. 

INFLAMMATION OF THE BLADDER. 

Symptoms. Pain and swelling of the bladder, — 
the pain increased by pressure, — a frequent desire to 
make water, which either comes away in small 
quantities or is totally suppressed. 

Causes. Inflammation of surrounding parts, — 
stone in the bladder,— suppression of urine. 

Treatment. Make warm application of water 
and narcotics over the bladder: put him into the 
warm bath. Inject mucilaginous and laxative 
clysters, and pursue the exact plan of treatment 
that is recommended for the cause from which it 
may proceed. See Suppression of Urine, &c. 



DIFFICULTY OF URINE. 

Symptoms. A frequent desire to make water, at- 
tended with pain, heat, and difficulty in doing so, — a 
fullness in the bladder. 

Causes. The urine having been retained too long 
—Spanish flies taken internally, — gravel, — blisters, 
and all the causes of inflammation of the bladder, — 
inflamed prostate gland, &c. 

Treatment. If it arise from simple irritation by 
blisters, &c. plentiful draughts of warm liquids, as 
gum arabic or barley water, will be sufficient to re- 
move it. If from any other cause, a bladder half 
filled with warm water, or cioths wrung out of a 
warm decoction of herbs, should be kept constantly 
applied over the parts, and mild clysters of thin starch 
be frequently injected. 




The Ureters, running from the Kidneys to the Bladder. — 
a Aorta, b Bifurcation, c Abdominal muscles turned 
down, d The rectum cut and tied, e Bladder. //Ure- 
ters, g g Kidneys. * 



Suppression of Urine. 71 



SUPPRESSION OF URINE. 

Symptoms. Pain and swelling of the bladder,— 
violent and fruitless attempts to make water, attended 
with excruciating pain, &c. 
Causes. The same as in a difficulty of urine. 
Treatment. As a total suppression of urine is 
always attended with considerable danger, there 
should be no delay in endeavouring to remove it. 
Chloroform the patient to relieve the spasms, or he 
should be placed in the warm bath. While he is there 
a laxative and anodyne clyster must be got ready, 
which is to be given as soon as he leaves it, and fre- 
quently repeated. In the mean time the warm 
fomentations, and a bladder of hot water must be 
kept applied, and No. 23 be taken every three or 
four hours. If there be any difficulty in procuring it, 
twenty drops of laudanum in a little warm barley or 
rice water, or a decoction of the dandelion will an- 
swer in stead. Warm sweet oil or milk and water 
may be injected up the urethra, and 6 or 8 grains of 
camphor in a little milk be taken every hour. 

If no relief is obtained by these means, con- 
sult a physician, and ascertain whether the 
trouble is located in the kidneys, in the passage 
from the kidneys to the bladder, in the bladder, 
or in the urethra. There are instruments, called 
catheters, of various kinds, sizes and shapes, 
made to draw off the urine from the bladder; 
and by having an experienced hand pass one 
of these up the urethra, into the bladder, and if 
several ounces of urine is drawn off, it will be 
recognized that the trouble is with the urethra 
or bladder, but if no water is obtained, then the 
trouble is above the bladder. In cases where 
there is retention in bladder, the longer the 
urine is allowed to remain, the more the blad- 
der is distended, and the more irritating the 
urine becomes to the mucus lining ; and accord- 
ingly the more aggravated the condition 
grows, and the chances of relief are more dim- 



72 Compendium of Domestic Medicine. 



cult; therefore by having the right kind of 
catheter selected, and passing it early, the 
patient is spared much discomfiture, as well as 
the risk of a more serious termination. In 
suppression of urine from any cause, the 
patient will die in a few days unless the flow 
of urine can be re-established. 



INCONTINENCY OF URINE. 

Symptoms. An involuntary dribbling or flow of 
urine. 

Causes. A relaxative or paralytic affection of the 
bladder, — excessive venereal indulgences, — a dis- 
eased state of the bladder, — stone in the bladder. 

Treatment. If it arises from a relaxation or weak- 
ness of the parts, use the cold bath daily, apply blis- 
ters between the fundament and the bag, and have 
recourse to bark and the different tonics, as iron, &c. 
recommended in indigestion. Twenty or thirty grains 
of the uva ursi, twice or three times a day, with half 
a pint of lime water after each dose, may also be 
tried. If the disease is occasioned by a palsy of the 
parts, the tincture of Spanish flies may be of service, 
[f a stone in the bladder is the cause, apply to a sur- 
geon to cut it out. In the mean time, some kind of 
vessel should be attached to the penis, to receive the 
urine, in order to prevent it from excoriating the 



STONE IN THE BLADDER. 

Symptoms. A frequent desire to make water, 
which comes away in small quantities at a time, and 
is often suddenly interrupted, the last drops of it oc- 
casioning pain in the head of the yard, — riding over 
*i rough road, or any irregular motion, or jolting 



Stone in the Bladder, TS 



jauses excruciating pain and bloody urine, accom- 
panied with a constant desire to go to stool, — itching 
of the fundament, — a numbness in the thighs, &c- 
retraction or drawing up of the testicle. 
Treatment. Apply to a surgeon. 



DIABETES, OR AN IMMODERATE FLOW OF 
URINE. 

Symptoms. Frequent discharges of large quanti 
lies of urine, which is sometimes of a sweet taste, — 
.skin dry, — bowels costive, — appetite voracious, — 
weakness, and gradual emaciation of the whole body. 

Causes. A shattered constitution, — immoderate 
venereal indulgences, — spirituous liquors,— cold — 
suppressed perspiration. 

Treatment. The principal remedy for the cure 
of this disease, consists in confining the patient to a 
diet composed exclusively of animal food. Blisters 
may. also, be applied over the kidneys and kept open 
with ihe savine ointment. The prescription No. 24,* 
has proved eminently successful. The carbonate of 
ammonia, in doses of 11 or 12 grains three limes a 
day, is strongly recommended, upon high aulhonty. 
In addition to these, opium in liberal doses, exercise 
on horseback, the flesh-brush, and flannel next the 
skin are not to be neglected. The bowels should be 
kept open by rhubarb. 



DROPSY OF THE BELLY. 

Symptoms. A swelling of the belly, from water 
contained in it, preceded by a diminution of urine- 
dry skin, and oppression at the breast. 

* Of Dr Ferriar, of Manchester, England. 



74 Compendium of Domestic Medicine. 

- Causes. Diseases of various kinds, — intemper- 
ance, — a dropsical disposition. 

Distinguish it from tympany by the absence of 
rhe rumbling of the intestines, belching, colic, and 
hollow sound which characterize the latter : 

From other diseases, by placing one hand on the 
belly, and gently striking it on the opposite side with 
the other, when a wavy or tremulous motion will be 
felt, resembling that occasioned by the agitation of 
water in a basin 

Treatment. One of the most valuable remedies 
for dropsy is found in the elaterium, (the dried ex- 
tract) one fourth of a grain of which is a dose. As it 
is a most active article, it is proper to begin with one 
sixteenth of a grain daily, which may be cautiously 
increased to a fourth, or till it is found to exert its full 
powers by bringing away large w r atery stools. From 
an ounce to an ounce and a half of cream of tartar, 
dissolved in water, and taken daily, has frequently 
succeeded in removing the complaint. As objections 
are sometimes made to the quantity of this latter arti- 
cle it is necessary to use in this w r ay, half an ounce 
of it, w 7 ith one or two grains ofgamooge, every other 
day, may be substituted for it. Six grains of calomel, 
with one or two of gamboge, taken twice or ihree 
limes a week, have cured the disease. Bathing the 
feet before going to bed, and taking immediately 
after 20 grains of Dover's powder, by producing copi- 
ous sweating, has had the same effect. 

Dropsy is, notwithstanding, a difficult disease to 
cure. It must r±e attempted, however, by the use of 
such articles as we have mentioned, beginning with 
the first, and if it fail, proceeding to the next and so 
on. If the swelling increases to such an extent as to 
be absolutely insupportable, send for a surgeon to 
draw off the water. At the decline of the disease, 
the strength must be supported and restored by bark, 
wine and the tonic plan recommended for indigestion 



Tympany. 75 



TYMPANY. 

Symptoms. The symptoms of tympany or a col- 
lection of air either in the intestines themselves, or 
in the cavity of the belly, are more or less gradual in 
their approach. When the disease lies within the 
intestines, it commences with wind in the stomach 
and bowels, which keeps up a constant rumbling, 
belching, &c. — colic, — costiveness, — diminution of 
urine, — want of appetite, &c. When it is in the 
cavity 'of the belly and outside the intestines, the 
swelling is much greater, and very elastic, when it 
is struck, giving a hollow sound like a drum, — there 
is no belching, &c. 

Causes. Weakness of the bowels, — intemperance, 
—a vegetable diet 

Distinguish vrfrom dropsy, which see. 

Treatment. If the complaint is within the intes- 
tines, keep the nozzle of a clyster pipe up the funda- 
ment, to permit the wind to pass through it, in order 
to diminish the pressure on the bowels. Warm mint 
tea, ginger, horse-radish, ether, Cayenne pepper, 
spices and essential oils, with laxative medicines and 
clysters, should be freely used, with a moderately 
tight broad bandage round the belly. If these means 
do not answer the end, warm and active purges must 
be resorted to, such as the compound tincture of 
senna, or jalap, or any of the Nos. 25, 26, or 27. If no 
relief is obtained and the costiveness continues obsti- 
nate, apply pounded ice to the belly. Rubbing .t 
with turpentine may, also, prove useful It is very 
apt to terminate in death. 



GONORRHOEA. 

Symptoms. A tingling sensation at the end of the 
penis, which swells, looks red and inflamed, followed 



76 Compendium of Domestic Medicine. 

Dy a discharge of matter that stains the linen, first of 
a whitish, then of a yellow or green colour, — a scald- 
ing pain in making water, — involuntary and painful 
erections. 

Treatment. There are two kinds of this affection, 
the mild and the virulent. The first is of so trivial a 
nature, that plentiful draughts of any soothing liquid, 
as barley water or flaxseed tea, with a low diet, are 
sufficient to remove it. The second produces effects 
more or less violent on different persons, and occa- 
sionally resists for months, every remedy that can be 
thought of. If the disease resist the low diet, &c. 
apply to a surgeon, and beAvare of trusting to the 
recipes of friends, or of employing their injections. 
Strictures and other horrid consequences are the most 
probable results of tampering with this disorder. If 
at sea, however, you may use an injection composed 
of five grains of sugar of lead and eight or ten of 
white vitriol, dissolved in half a pint of soft water. 



GLEET. 

Symptoms. The weeping of a thin glairy fluid, 
like the white of an egg, from the penis, caused by a 
long continued clap. 

Treatment. A gleet is exceedingly difficult to 
get rid of, and frequently defies every effort that is 
made for that purpose. It must be attempted, how- 
ever, by the daily use of the cold bath, and 30 drops 
of the muriated tincture of iron, taken three times a 
day, for months, in a glass of the cold infusion of bark. 

N. B. This complaint if let alone or badly treated 
is apt to end in an exhausting and incurable disorder. 
You had better seek the best medical advice within 
your reach. 



Involuntary Emissions. 77 



INVOLUNTARY EMISSIONS. 

Symptoms- An involuntary emission of semen 
during sleep, inducing great emaciation and debility. 

Causes. Excessive venery, — onanism, — every 
thing that weakens the seminal vessels. 

Treatment. Abstain from all sexual indulgence 
and lascivious ideas or books, — sleep on a hard bed, 
— use the cold bath daily, with a generous and 
nourishing diet. Chalybeate water and all the dif- 
ferent preparations of iron, with the cold infusion of 
bark and elixir of vitriol, as directed for indigestion, 
should be freely employed. 



STRICTURES. 

Symptoms. A difficulty in passing water, which, 
instead of flowing in a full stream, either dribbles 
away, twists like a corkscrew, or splits and forks in 
two or three directions. They are occasioned by 
strong injections, — long continued or ill treated clap. 
The cause, however, is not always to be satisfactorily 
ascertained. 

Treatment. Apply to a surgeon: you can do no- 
thing to rid yourself of the disease but this, — terrible 
are the consequences of meddling with it yourself. 



SYPHILIS. 

Symptoms. Chancres and buboes are among tho 
first symptoms of this dreadful malady, which, if not 
checked, goes on to cause an ulcerated throat, nodes, 
a destruction of the bones and cartilages of the nose, 
and the palate. The voice is lost, — the hair falls off, 
—foul spreading ulcers show themselves all over the 



78 Compendium of Domestic Medicine. 

body, the stench of which is insupportable, and be- 
fore he dies, the miserable victim to it becomes a 
loathsome mass of corruption. 

A Chancre at first resembles a pimple, with a 
little pit or depression containing matter, which soon 
becomes an ulcer, with an irregular thickened edge, 
covered with a tough, ash-coloured matter, the basis of 
which is hard and surrounded by inflammation. It is 
generally found on the foreskin or head of the penis. 

A Bubo is an enlargement of a gland in the groin, 
beginning in a small hard lump, not bigger than a bean, 
aiui increasing to the size of a. hen's egg. 

A Node is a hard tumour formed on a bone. 

Treatment. N.B. Apply to a surgeon on the 
first indication or even suspicion of this most horrible 
disease, — if taken at an early period, and properly 
treated, it is soon cured, — but if neglected, or impro- 
perly attended to, its consequences are too dreadful 
to be detailed: a lingering death, and a putrescent 
body, are what you may expect. Give no confidence 
to the recipes of friends, but apply to a physician at 
once. 



CANCER OF THE PENIS. 

Symptoms. A small tumour like a wart, upon the 
head of the penis or foreskin, followed by inflamma- 
tion and ulceration, which discharges a thin dis- 
agreeable fluid, — after a time, a cancerous fungus is 
produced, attended by a most intolerable burning 
and darting pain. 

Treatment. Apply at once to a surgeon, whi 
will amputate it. Death is the onV alternative. 



Venereal Warts. 79 



VENEREAL WARTS. 

Crops of these animal mushrooms sometimes spring 
up round the head of the penis, or on the foreskin. 
l£Jlat, they may be destroyed by caustic; if mounted 
on a stem or foot-stalk, by tying a piece of thread 
tight.li/ round it 



MERCURIAL DISEASE. 

This is a complaint whose symptoms nearly re- 
semble the secondary ones of pox, consisting of 
blotches on the skin, — pains at night, — ulcers in the 
mouth, &c. &c. Owing to the liberal use of calomel, 
it is now a very common disease, which is frequently 
confounded (even by medical men) with genuine 
syphilis. 

* Treatment. Abandon every mercurial prepara- 
tion, — use the decoction of guaiacum and sarsaparilla, 
— the warm bath, and a mild nourishing diet. If 
possible, remove to a healthy situation in the country. 
It is also necessary to take an occasional purgative 
of the flowers of sulphur or of rhubarb. 



DROPSY OF THE SCROTUM. 

Symptoms. A collection of water, which is first 
perceived at the bottom of the scrotum, increasing in 
size as it advances upwards, and forming a tumour 
of the shape of a pear. If examined as directed 
for dropsy of the abdomen, the wavy motion may 
be felt, and if a candle be placed behind it, i* 
becomes partly transparent. 

Distinguish it from a rupture, by the tumour not 



80 Compendium of Domestic Medicine. 

swelling when the patient coughs, — by the tumour 
having commenced at the bottom of the scrotum, <feo. 

From a diseased testicle, by its softness, — the natu- 
ral colour of the skin, — absence of pain, — transpa- 
rency, &c. &c. 

Treatment. When it is first discovered, attempt 
to disperse it, by bathing it frequently with No. 2a 
The only certain cure is an operation, for which, as 
there is no pressing danger, apply to a surgeon. 



ENLARGED SPERMATIC VEIN. 

Symptoms. A hard knotty and irregular swelling 
of the vein, which sometimes increases to a large 
size. When lying down, the swelling diminishes, 
which distinguishes it from a dropsy of the parts. 

Treatment. Suspend the testicles, or keep the 
patient on his back, — apply the lotion No. 28, to the 
parts, — the cold bath. 



CANCER OF THE TESTICLE. 

Symptoms. The testicle is enlarged, — hardened. 
— craggy and unequal in its surface, — painful on be- 
ing handled, with irregular pains shootuig up the 
groin, into the back, without any previous inflamma- 
tion, disease, or external violence. 

Treatment. Apply immediately to a surgeon. 
Castration, and that at an early stage of the disease, 
is the only remedy that can save life. Be careful, 
however, to distinguish it from simple swelling of 
the testicle by inflammation, blows &c. Which see 



Impotency. 81 



IMPOTENCY. 

This is of three kinds. The first arises from an 
original defect in the organs of generation. The 
second, from local debility of the parts, brought on by 
excessive venery, onanism, or some preceding dis- 
ease : while the third originates from fear, excess of 
passion, or want of confidence at the moment of 
coition. 

The first is incurable. The second must be treated 
by the general principles and remedies already 
pointed out for restoring the strength of the system, 
consisting of the cold bath, preparations of iron, bark, 
elixir of vitriol, generous diet, exercise, and by steadily 
avoiding the causes which may have produced it. The 
remedies for the third, must be sought for, in calm- 
ing excessive agitation, and acquiring, by habits of 
intimacy, that confidence they are sure to produce. 



GOUT 



Symptoms. Pain in the small joints, generally m 
the ball of the great toe, — the parts swollen and red, 
—the attack coming on in the night. Such are the 
striking symptoms of this disease, and generally the 
first that are noticed. It is occasionally, however, 
preceded by all those attendant on indigestion. In 
the advanced stages chalky lumps are formed in the 
joints. 

Causes. A too free use of the good things of this 
world, — a disposition to it from parents. 

Distinguish it from rheumatism, by the pain, &c 
being in the small joints, &c. 

Treatment. If the patient be young, vigorous, — 

having the disease for the first time, give citrate of 

magnesia, confine him to a low diet, and treat it 

exactly as an inflammation arising from any other 

F 



82 Compendium. of Domestic Medicine, 

cause. To procure sweating, Dover's powder may 
be taken on going to bed. As soon as the inflam- 
mation, by these means, is reduced, use the cold 
bath, and take strong exercise on foot, daily, — avoid 
high seasoned food, feather beds, wine, acids and 
fermented liquors, for the remainder of your life ! 
Gout is the child of indolence and intemperance, 
and to avoid it, the above means must be em- 
ployed, and steadily persevered in. 

It) however, the patient is old or infirm, and sub- 
ject to regular fits of it, he must not be handled so 
roughly. The most perfect rest should be observed, 
and the parts lightly covered with fleecy hosiery, and 
flannel cloths wetted with the lotion No. 29, made 
milk-warm. The bow T els should be opened with 
some warm laxative. In a regular fit of the gout, 
this is all that can be done. The degree of warmth 
that is applied to the part, must be regulated by the 
feelings of the patient, who if weak, may use a nour- 
ishing diet, if strong, a more abstemious one. 

If from any cause, the disease leaves the extremi- 
ties and flies to the stomach, apply mustard poultices 
and blisters to the soles of the feet and ankles, — give 
Jarge doses of ether and laudanum, hot wine, brandy, 
&c. and endeavour by all such means (including the 
hot bath) to send it back again; 

If the head be the part it is transferred to, and 
apoplexy is produced by it, take away 15 c. 20 ounces 
of blood immediately, and give active purgatives, as 
10 or 15 grains of calomel, followed by senna tea, or 
Epsom salts. If in a few hours, the patient is not 
relieved, the head continuing confused and painful, 
and the pulse full and throbbing, apply cold vine- 
gar and water constantly to the part. 



INFLAMMATORY RHEUMATISM. 

Symptoms. Pain, swelling and inflammation in 



Inflammatory Rheumatism. 83 

some one (or several) of the larger joints. The 
pain shifting from one part to another, — all the 
symptoms of fever, — pulse full and hard, — tongue 
white, — bowels costive and urine high coloured. 

Causes. Cold, — suppressed perspiration, — wear- 
ing damp clothes, &c. 

Treatment. If fever is present, reduce it and 
the acidity of the urine and system by doses of 
5 to 8 grs. of bicarbonate of potash. If consti- 
pation be present, give a saline purge. After the 
fever is removed, give 5 grs. of iodide of potas- 
sium and 10 drops of tr. colchicum 3 times 
daily, — if much pain is present, add a £ to £ of a 
grain of sulphate of morphia. If there are pe- 
riods of intermission in the disease, give large 
doses of quinine, 20 to 30 grs. in 24 hours. Lemon 
juice and sugar, half ounce hourly, has been 
found to be good. If the heart becomes affected, 
give 5 gr. doses of the iodide of potassium mix- 
ture with tr. of digitalis, and apply cups over 
the region. 

CHRONIC RHEUMATISM. 

Symptoms. A chronic rheumatism is nothing 
more than one of long standing. It is unaccom- 
panied by fever, and makes its attacks on every 
change of weather, on getting wet, &c, &c. It 
is frequently caused by inflammatory rheumatism, 
and sometimes seems to exist as a primary affec- 
tion. 

Treatment. I have found no one plan of treat- 
ment in this species of the disease, so effectual as 
the following : purge with senna and salts, every 
other day, — rub the parts well with the liniment 
No. 30, apply a blister of the parts affected, or paint 
with tr. of iodine, and on going to bed 30 drops of 
laudanum, with a tea-spoonful of the tincture of 



84 Compendium of Domestic Medicine. 

g uaiacum. It is to be recollected, that this is applica- 
ble only to chronic cases; if there is fever, &c. it will 
io much damage. The best safeguard against the 
complaint is the use of flannel next the skin, winter 
ind summer. 



HIP-JOINT DISEASE. 

Symptoms. Excruciating pain in the hip-joint and 
knee, — the leg becomes first longer, then shorter than 
its fellow. When lying down the foot rolls outwards, 
the buttocks appearing flatter than usual, — lameness, 
— after a while abscesses in various parts of the thigh, 
— hectic fever, &c. 

Causes. Scrofula. 

Treatment. This should be treated carefully 
and constitutionally; the limb must be kept at 
rest, and put into a proper machine. Cod liver 
oil and tonics must be given freely, with all the 
remedies necessary for the treatment of scrofula. 
A generous diet of good food, beef and wine, must 
not only be allowed, but insisted on. Reducing 
the system by purging or bleeding should never be 
allowed, as the system of all scrofulous patients 
should be built up and not reduced if a cure is 
wished to be arrived at. 



DROPSY OF THE KNEE JOINT. 

Symptoms. The joint swells, the skin remaining 
of a natural colour. By placing the hand on one side 
of it, and striking it gently on the other, the wavy or 
fluctuating motion is perceptible, — steady pressure on 
one side will raise the other above its natural level. 

Causes. A dropsical disposition, — debility, — rheu- 
matism, — scrofula, — syphilis. 

Treatment. Keep a perpetual blister on the joint, 



Dropsy of the Knee Joint. 85 

or make a caustic issue below it, on the inside of the 
leg, — cold water from the spout of a tea kettle, is a 
useful application. Camphorated mercurial oint- 
ment to the knee, and mercury taken internally 
have sometimes been of service. 



WHITE SWELLING. 

Symptoms. Deeply seated pains in the knee, un- 
attended at first by swelling, which at last comes on 
with increase of pain. After a while the joint en- 
larges, — matter is sometimes discharged,— hectic 
fever follows, and cuts off the patient. 

Causes. Scrofula, — blows, — inflammation from 
any cause. 

Treatment. If from scrofula, use the general 
remedies directed for that disease, and apply a blister 
to the part, which must be kept open by the savine 
ointment, for months: if from blows, apply the blister 
as before, keep up the system with tonics, and give 
a good generous diet. If in spite of these pre- 
cautions, the disease continues to advance, amputa- 
tion is the only resource. 



PIECES OF CARTILAGE IN THE JOINTS. 

Portions of cartilage are sometimes formed in joints, 
where they act like any other foreign body of a simi 
lar texture. While in the hollows of the part, they 
give no uneasiness, but as they frequently slip m 
between the ends of the bones, causing excruciating 
pain, it is sometimes necessary to cut them out. Foi 
this purpose apply to a surgeon. As all openings into 
the cavities of the joints are attended with much 
danger; unless the pain be insupportable, it ; s better 



86 Compendium of Domestic Medicine. 

to endure the inconvenience than to run the risk of 
the operation. 



SCROFULA, OR KING'S EVIL. 

Symptoms. Hard and indolent swellings of the 
glands of the neck, thai when ripe, instead of matter, 
discharge a whitish curd. It mostly occurs in per 
sons of a fair complexion, blue eyes, and delicate 
make. In bad cases, the joints swell with great pain, 
— the limbs waste away, — the ligaments and bones 
are destroyed, when hectic fever soon relieves the 
patient from his misery. 

Causes. Inheriting the disease from parents,— 
moist cold air, — a poor diet, &c. 

Treatment. Sea-water is a great remedy in 
scrofula. It is to be used daily as a bath, and a 
small portion of it taken internally. Made milk- 
warm, it forms one of the most excellent local 
applications that we have. Against the enlarge- 
ment of the glands, paint with tr. of iodine and 
give iodide of potassium inwardly. The diet 
should be mild and nourishing. Scrofula is sel- 
dom, if ever, cured. If the glands become perma- 
nently enlarged, and by no means can be reduced, 
then apply to a surgeon for their removal if un- 
sightly or troublesome. 



INFLAMED GLANDS. 

Every gland in the body is subject to inflammation 
Whenever one of them is perceived to be in this 
state, Which may be known by the swelling and pain 
measures should be taken to reduce it, for fear of its 
proceeding to what is called scirrhus, and finally to 
cancer. Leeches, blisters, and all the- remedies 
directed for such purposes, should be actively em- 




GLANDS. 



Inflamed Glands. 87 

ployed, among which tr. iodine and a good diet 
must not be neglected. 



SCIRRHUS. 

Symptoms. A hard tumour, unequal on its sur- 
face, and not very sensible, giving but little or no 
pain on being handled. 

Treatment. Apply to a surgeon without loss 01 
time for fear of a cancer. 



CANCER. 

Symptoms. A tumour, differing from the preced- 
ing one by being surrounded with enlarged veins. 
It is, also, more painful, the skin being sometimes 
discoloured and puckered. The whole tumour is 
particularly heavy, and at last breaks into a malignant 
ulcer or sore, whose edges are raised, ragged, un- 
even, and curl over like the leaves of a flower, — 
white streaks or bands cross it from the centre to the 
circumference. Acute and darting pains accompany 
ooth this and the preceding stage of the disease. 

Treatment. There is but one remedy that can 
be depended on for the cure of this painful and in- 
veterate complaint, and even that should be resorted 
to early, in order to ensure success. All the diseased 
parts must be cut out. Arsenic, corrosive sublimate, 
phosphate cf iron, and a thousand other articles, have 
been recommended, both externally and internally, 
but without any effectual advantage. To relieve the 

f)ain, opium may be taken in large doses. A very 
ow diet (such as is barely sufficient to support life) 
of milk and vegetables, will produce the same effect. 
The sore should be defended from the air, by some 
mihi ointment. Powdered chalk, scraped carrots, 



88 Compendium of Domestic Medicine, 

fresh hemlock leaves, and powdered charcoal, may- 
be used for the same purpose. 



GOITRE. 

Symptoms. A tumour in the fore-part of the t hroat 
seated in a gland close to the projection called 
" Adam's apple." 

Causes. These are not ascertained. They are 
supposed to consist of some peculiarities in the water 
of those places where it is common. 

Treatment. Goitre is incurable. When taken 
at the very beginning of the complaint, however, and 
in young persons, it is said to have been dispersed 
by a course of mercury, joined to frictions of the part 
with strong mercurial ointment. 



FAINTING. 

Causes. Sudden and violent emotions of the mi rut, 
—bleeding,— diseases of the heart and its great vessels. 

Treatment. Lay the person on the back, and 
raise the feet, then open the doors and windows, 
and sprinkle cold water in the face. Smelling 
salts may be held to the nose. 



APOPLEXY*. 

Symptoms. Falling without sense or motion, — 
profound sleep, — face livid or flushed, — eyes wide 
open or half closed, and immovable, — breathing low 
labouring and irregular. 

Ca uses. A rushing of blood to the head , excessive 
<at in persons with a short nee k, — gluttony, — violent 



Apoplexy. 89 

exercise, — intense heat, — anger, — hearty meat sup- 
pers, — blows on the head, — intoxication, &c. &c 

Treatment. If the pulse remain full, — the face 
flushed, &c. take away twenty ounces or more of 
blood on Hie spot, remove the cravat, unbutton the 
shirt collar, and place the patient in bed, with the 
head and shoulders a little elevated. The windows 
and doors must be thrown open, and no more persons 
than are necessary, be allowed to remain in the room. 
The head is to be shaved and cupped, a blister ap- 
plied to the back of the neck and the head, and mus- 
tard poultices to the feet. An active purgative* 
should always be administered, as soon as the patient 
is bled, and its operation assisted by repeated clysters. 
If by these means, the breathing is not easier, and the 
pulse softer, bleed again, and again. 

I£ however, the patient is old and infirm, and the 
attack has come on more gradually, if the pulse is 
weak, and the face pale, do not bleed, but give 
immediately a warm purgative, apply the blisters, 
&c. If it arises from swallowing vegetable poisons, 
give an active emetic, as 30 grains of white vitriol, 
and act as directed in cases of similar accidents. In 
this second kind of apoplexy, stimulants, as hartshorn 
to the nose, &c. may be used ; in the first, they are 
very injurious, and should never be employed. 



SUN-STROKE. 

This proceeds from exposure to the sun's rays, and 
exlubits the same symptoms as apoplexy, commencing 
with vertigo, loss of sight, ringing in the ears, &c- 
and must be treated by large and repeated bleedings, 
and in every other respect as directed for apoplexy. 



* If the patient cannot swallow pills, try liquids ; if 
neither, have recourse to a strong purgative clyster 



90 Compendium of Domestic Medicine. 



EPILEPSY. 

Symptoms. A lit, in which the patient falls to the 
ground in a convulsion, — the eyes are distorted and 
turned up, — hands clenched, — foaming at the mouth, 
— convulsions, — the whole ending in a deep sleep. 

Causes. Sudden fright, — anger, — injuries done to 
the nerves, — unknown. 

Treatment. Keep the patient from hurting him- 
self, by holding his hands, legs, and particularly his 
head, which he is apt to dash violently against the 
ground or surrounding objects. A piece of soft wood 
should be placed between his teeth, to prevent his 
tongue from being bitten. This is, in general, all that 
can be done during the fit. Give twenty gr. doses 
of bromide of potassium three times daily. 



CATALEPSY. 

Symptoms. A sudden suspension of the action 
of the senses, and of volition, the body and limbs 
preserving the position given them, while the 
action of the heart and lungs continues. 

Treatment. Electricity, cold douches, chloro- 
form inhalation, and irritation of the skin during 
the spasm. In the intervals, if from intermittents, 
quinine, if from cold, warm and sulphur baths, if 
from hysteria or catamenia difficulties, anemia, &c, 
use the general remedies recommended therefor. 



Palsy. 91 

PARALYSIS OR PALSY. 

Symptoms. A partial or complete loss of the 
powers of motion, and the sensibility of particular 
parts of the body, — the pulse soft and slow. 

Causes. Apoplexy, — pressure on the nerves, from 
blows, wounds, &c. — the fumes of lead, mercury, <fcc. 

Treatment. The treatment must be according 
to the cause. By the idiopathic and pure nervous 
palsy, attention must be called to the spinal column 
as the seat of the disease, for which nux vomica, 
zinc, stramonium, steel baths, cold baths, and moxas 
down the column, are of service. Magnetism down 
the back, from the back of the head to the end of 
the back-bone, is often of use. It is well always in 
the use of electricity to begin with a weak current. 
The continual electrical stream upon the limb has 
produced cures. After the misuse of mercury or 
mercurial preparations a palsy of the limbs takes 
place, for which opium or morphium is recom- 
mended ; also electrical baths. If occasioned by 
pressure on a nerve or by the misuse of too strong 
coffee, tea, or tobacco, the cause must be removed. 



TETANUS, OR CRAMP 

There are several very long and very learned 
names affixed to this disease. When it is confined 
to the muscles of the neck and jaws, locked-jaw is 
the common and expressive term for it. The affec- 
tion, however, is always the same, requires similar 
treatment, and consists in an involuntary contraction 
and stiffening of a part of the muscles, the senses 
remaining perfect. 



92 Compendium' of Domestic Medicine. 



LOCK JAW— TETANUS. 

Symptoms. Pain and stiffness in back of neck, 
— eventually head cannot be rotated,— difficulty 
in swallowing- and speaking, — lower jaw be- 
comes stiff and cannot be opened, — spasmodic 
rigidity or cramping of nearly all the muscles 
so that they feel hard and knotty, — body be-, 
comes rigidly straight or bent backwards like 
a bow. 

Cause. Bacillus tetani found in soil of many 
localities, which gain access to the body by 
way of a wound or break in the skin. 

Treatment. The feet should be perfectly clad 
to insure against scratches and injuries. AIL 
wounds, no matter how trivial, made by nails 
or splinters, or by anything which might carry 
a particle of dirt beneath the skin, should be 
carefully cleansed. In this way the disease 
maybe prevented. If disease is recognized to 
be coming on place pieces of soft wood between 
the grinders, on both sides, so that the jaws 
will not close entirely. Perfect quietude. Feed 
the patient liquid foods by means of a rubber 
tube inserted between the teeth, or through the 
nostrils, or by giving rectal enemas. Have the 
antitoxin for tetanus injected by a physician. 
This comes nearer to arresting the disease 
than any other treatment. Other remedies are 
given merely to relieve distressful symptoms, 
without hopes of a cure; if, however, the patient 
is relieved for a time, physical indurance may 
tide till recovery. Ten grains of chloral hydrate 
and 15 grains or bromide of potash may be 
given every two hours for several doses. When 
the muscles are contracting give a few whiffs 
of chloroform until the muscles relax. Opium 
and morphine often do excellent service in this 
disease. Burn all dressings, to prevent others 
from being infected. 




DISTRIBUTION OF THE FACIAL NERVE AND OF 
THE BRANCHES OF THE CERVICAL PLEXUS. 

1, The facial nerve at its emergence from the stylo- 
mastoid foramen. 2, temporal branches communicating 
with (3) the frontal branches of the fifth or trifacial 
nerve. 4, infra-orbital branches, communicating with 
(5) the infra-orbital branches of the fifth nerve. 6, 
"maxillary branches communicating with (7) the mental 
branch of the fifth nerve. 8, cervico-facial branches. 
9, the spinal accessory nerve giving off a branch to 
the trapezius muscles. 



Facial Neuralgia. 93 



FACIAL NEURALGIA. 

This disease is also called tic- douloureux, 
and varies in severity from a moderate distress 
to that of an unbearable intensity. 

Symptoms. Darting pain in the region of one 
or more branches of the facial nerve, usually 
affecting only one side of the face at a time, 
and remains in a circumscribed area, over the 
temple, cheek or side of chin. These paroxysms, 
as a rule, last not more than a second, recurring 
rapidly, with intervals, in some cases, when 
there is no pain whatever. It is rare that swell- 
ing occurs and all signs of inflammation are 
absent. Occasionally there is intolerance of 
light; the eye on the affected side is blood-shot; 
and there is an extra flow of saliva. 

Cause. Debility, — anemia, — malarial poison- 
ing, decayed teeth, — exposure to cold, etc. 

Treatment. Seek to find the cause, and re- 
move that as early as possible. If there are 
decayed teeth, have a dentist treat it; if there 
is malaria, take large doses of quinine; if 
anemia, take iron and arsenic; and if debility, 
endeavor to build up the general physical con- 
dition. To relieve the pain, large and frequent 
doses of castor oil act more satisfactorily than 
any other remedy. This is harmless and worthy 
of a trial in every instance. It should be taken 
in not less than two tablespoonful doses every 
two to four hours. It may be taken in foaming 
porter or in brandy, to avoid the disagreeable 
taste. Antipyrine in 5 to 10 grain doses repeated 
every hour for four or six doses will generally 
soothe the pain ; but sometimes it may be justi- 
fiable to use an opiate. Warmth applied ex- 
ternally generally affords some relief, and this 
may be done by means of a rubber hot water 
bottle or cloth bag filled with dry bran which 
has been heated in an oven. It is always ad- 
visable to rapidly saturate the system with 



94 Compendium of Domestic Medicine. 

quinine; take 10 drop doses of the tincture of 
the Chloride of iron in an empty gelatine cap- 
sule before each meal, and 5 to 8 drops of 
Fowler's solution of arsenic in water, also at 
meal time. Eat plentifully of dark meats. 



SCARLET FEVER. 

Symptoms. Langour or restlessness, followed 
by chilliness, — headache, — sore throat, — fever, 
— skin hot and dry, — tongue moist and white, — 
bright red at tip and edges, — papillae swollen 
and red, giving the appearance of a straw- 
berry to the tongue ;— rapid pulse, great thirst, 
frequently nausea and vomiting. The eruption 
first appears as bright-red pin-head spots, 
which gradually run together and make the 
skin of uniform scarlet tint. After four or five 
days' duration the rash disappears and a bran- 
like peeling off of the skin takes place — the skin 
sometimes coming away in large flakes. 

Cause. A bacteria peculiar to the disease 
found in the secretion of mouth and throat 
and in the scales from the skin. 

Distinguish it from measles by the spots com- 
ing out on the second day of the fever (in 
measles they seldom appear until the fourth 
day) ; by their color which is that of a boiled 
lobster, whereas in the measles it is of a dark 
red. 

Treatment. This being a contagious disease, 
the first thing to do is to isolate the patient in 
a room free from draughts and inequalities of 
temperature, give hot lemonade or hot drinks 
at intervals to bring out eruption, with plenty 
o± cool drinks between times. Use liquid 
citrate of magnesia if bowels are constipated, — 
sponge with water to relieve restlessness and 
reduce fever, following the directions for spong- 
ing given for simple fever. Where there is 



Scarlet Fever. 95 

itching add one teaspoonful of carbolic acid to 
each quart of water that is used for sponging. 
If there is much fever take one tablespoonful 
of the spirits of Mendereri every two hours. 
After the peeling off has begun, annoint the 
body twice daily with carbolized vaseline, 
which prevents the scales from flying and 
allays the itching. Serious complications are 
liable to set in at any stage of this disease, and 
for that reason they must constantly be 
guarded against. Acute inflammation of the 
kidney and of the middle ear, are two of the 
most frequent complications. The best pre- 
ventive against kidney trouble, is the copious 
drinking of water throughout the disease; and 
the best against ear complications, the fre- 
quent cleansing of the throat with No. 36. On 
account of Scarlet Fever being very contagious, 
the utmost precautions regarding disenfection 
must be followed. 



DANCE OF ST. VITUS. 



Symptoms. Irregular and convulsive motions 
of the limbs and head, generally of the arm and 
leg of one side only. It varies, however, in dif- 
ferent persons, and is frequently counterfeited 
by beggars. 

Causes. Weakness of the nerves, — worms, — 
posions, — fright, &c. 

Treatment. The daily use of the cold bath, 
with the Peruvian bark^ has often succeeded 
in curing the complaint in young subjects. In 
addition to these, any of the preparations of 
iron, No. 41, combined with large doses of musk, 
opium, camphor, &c. may be tried. Active and 
long continued purging sometimes produces 
the happiest results. 



96 Compendium of Domestic Medicine. 



ANGINA PECTORIS. 

Symptoms. An acute pain at the lower end of 
the breast bone, shooting into the left arm, — 
great difficulty of breathing, — anxiety, — palpi- 
tation of the heart, — a feeling of suffocation. It 
usually comes on while ascending a hill, or 
going up stairs. 

Causes. The vessels of the heart being 
turned into bone, — an accumulation of blood 
in the heart and its vessels. 

Treatment. During the fit, let the patient 
inhale sulphuric ether. If fainting, dash cold 
water in his face. Should this not arouse him 
in a few minutes, apply a blister to the chest. 
Strips of linen, moistened with the solution 
below,* applied several times a day to the 
breast bone, for a month, are said to have 
effected complete cures. They act by produc- 
ing a crop of pimples, on the appearance of 
which, the disease declines. 

Persons subject to this complaint, should 
avoid all fermentable food, an excess in eating 
or drinking, taking care to live quietly, and to 
keep the bowels open. Saline purgatives, fol- 
lowed by opium, to lessen the spasm, with the 
warm bath, and a perpetual blister or plaster 
of the tartar emetic ointment to the chest, are 
perhaps the best remedies that can be employ- 
ed. 

♦Tartar emetic, one drachm. Spirits of cam- 
phor, half an ounce. Boiling water, one pint. 
Mix. 



Erysipelas. 97 



ERYSIPELAS, ST. ANTHONY'S FIRE. 

Symptoms. In the beginning the symptoms 
are the same as in nearly all infectious fevers, 
viz.: Shivering, headache, — quickened pulse, — 
furred tongue and sometimes deranged stom- 
ach, then there follows a line of manifestations 
peculiar to this affection. There is a tingling 
and burning sensation, with stiffness and 
swelling of some particular part; and here a 
bright red spot appears, which soon spreads 
and turns to a dark purple. If the face is at- 
tacked, it extends itself on the scalp, and the 
eyelids generally swell so that the patient can 
hardly see, and often the features are obliter- 
ated. The swelling may be superficial, not 
causing a great amount of distress, or it may 
be deep seated and diffuse and produce intense 
suffering, owing to the tension on the skin. In 
the severe cases delirium is commonly present. 
After a few days the redness and swelling begin 
to fade away over the region first attacked. 
The duration of the disease varies from 7 to 10 
days, to several weeks, and at the termination, 
watery vesicles, blisters or scales appear 
where the inflamed cuticle existed. 

Cause. The streptococcus erysipelatous, which 
infects the attacked part through a break in 
the skin or mucus membrane. 

Treatment. Special care should be observed 
that the germs of the disease be not conveyed 
to those having wounds, or to women about to 
be or who have recently been confined, for if 



98 Compendium of Domestic Medicine. 

they should become infected, dire consequences 
would surely ensue. The fever may be reduced 
by one to two drop doses of the tincture of 
aconite and by the spirits of Mendereri. In case 
the bowels are constipated, keep them open 
with the liquid citrate of magnesia. When 
there is delirium, give calomel Y 8 to I grain 
doses every hour, until bowels are too free' 
and apply an ice cap to the head, lo the 
parts affected, apply lintine, which is kept 
saturated with the following mixture: ichthyol, 
Y 2 ounce, camphorated oil, ?% ounces. When 
the face is affected and the camphor vapor 
distresses the eyes, use the same proportions 
of ichthyol and cottonseed-oil. Carbolized 
vaseline spread over the part, also makes a 
satisfactory dressing. This disease if at all 
severe should be under the care of a physician. 



GERMAN MEASLES — THREE-DAY 
MEASLES— ROTHELN. 

Symptoms. Much the same as true measles, 
though considerably milder. Slight sorness of 
throat. A rose colored eruption appears, with 
the first symptoms of illness, which usually 
lasts but three days, hence the name three- 
day measles. 

Cause. A contagion identified solely with 
this disease. 

Treatment. Rarely any is needed, beyond 
remaining quietly within an evenly heated 
apart lent. 



Measles. 



MEASLES. 

Symptoms. Usually about eight days elapse 
after exposure before the disease shows signs 
of development. The early symptoms are 
weariness,— aching of head, back and limbs,— 
soreness of muscles, — chilliness, — fever comes 
on rapidly, — eyes red and watery,— sneezing, — 
nose running — cough, — and frequently vomit- 
ing. On the fourth day, small crimson points 
break out, first on the face, then gradually 
over the body. They are in clusters, running 
together, and on passing the hand over them, 
are found to be a little raised. On the fifth or 
sixth day, the vivid red is changed to a brown, 
the eruption fades, the fever abates, and a 
dandruff-like peeling off may follow. 

Cause. A particular contagion— of the erup- 
tive fevers, this is the most contagious. 

Distinguish it from small pox and all other 
diseases, by the dry cough and hoarseness, — 
by the appearances of the eyes, which are red, 
swollen, and loaded with tears. 

Treatment. Confine patient in bed in a well 
ventilated room, free from draughts, kept at 
a temperature of from 68° to 70°. The room 
must be darkened because exposure of the eyes 
to light may cause them to be permanently 
weakened. Give plenty of cool drinks, and. 
feed patient on liquid foods, chiefly milk. If 
eruption does not come out freely, give hot 
drinks until perspiration ensues — hot mustard 
foot bats accelerates this. Regulate the bowels 
with magnesia. The fever is to be treated the 
same as a simple fever without any fear of 
evil effects from the tepid sponging. Guard 
against taking cold, and any signs of lung- 
trouble are to be regarded as possible premo- 
nitions of a serious complication. For cough, 
inhale the steam from boiling vinegar, for five 
to ten minutes every one to four hours. 



Lift. 



100 Compendium of Domestic Medicine. 



CHICKEN-POX. 

Symptoms. Fever, — inability to sleep, — pain in 
different parts of the body, — a crop of small pimples 
or points on the back, which by the second day are 
changed into little blisters, which are ripe on the 
third and disappear before the fifth day, without 
forming true pus or matter, and leaving no marks or 
pits behind them. 

Distinguish it from small-pox, by the eruption 
coming out on the back, — by the mildness of the 
fever, — by the fluid contained in the vesicles or blis- 
ters not being true pus, and by the whole falling off 
in scales on the fifth day. 

Treatment. Confine the patient to his bed, — 
keep him cool and quiet, and give him a dose of salts. 
This is all that is necessary. 



COW-POX. 

Symptoms. A pimple at the spot where the mat- 
ter was inserted, which gradually undergoes certain 
regular changes, that characterize the complaint. 

CHANGES OF GENUINE COW-POX. 

On the second day, or sooner, from the time of the 
operation, a small speck of inflammation is to be per- 
ceived, which, on the fourth day is a pimple, sur- 
rounded by a circle of inflammation. On the fifth, 
this pimple changes to a vesicle containing a thin 
fluid. Cm the sixth, this vesicle is more perfect, its 
margin forming a regular circle; it is also a little flat- 



Cow-Pox. 101 



tened on the top, the centre of which is of a dark colour. 
On the eighth or ninth day, slight chills, flushes of 
heat, &c. are sometimes felt, accompanied by swell- 
ing of the pustule, and pains shooting up into the arm 
pit, the glands or kernels of which occasionally swell. 
On the tenth or eleventh day, the pustule is sur- 
rounded by a circular, vivid, inflammatory blush that 
is very beautifu I. This is regarded as a decisive proof 
of the presence of genuine cow-pox. On the eleventh 
day, the centre of the pustule begins to grow of a 
dark colour, which gradually increases to a brown or 
mahogany one by the end of the second week, when 
it begins to leave the skin, from wluch it is finally 



Treatment. If the pain, inflammation and swell- 
ing, are excessive, reduce them by cold applications, 
a dose of salts, low diet and rest. 



SMALL-POX. 

Symptoms. Inflammatory fever, — drowsiness, — 
pain in the pit of the stomach, increased by pressure, 
— pain in the back, — vomiting, — on the third day the 
eruption breaks out on the face, neck and breast, in 
little red points that look like flea-bites, and which 
gradually appear over the whole body. On the fifth 
day, little round vesicles, filled with a transparent 
fluid, appear on the top of each pimple. The erup- 
tive fever now declines. On the ninth day the pus- 
tules are perfectly formed, being round and filled 
with a thick yellow matter, the head and face also 
swelling considerably. On the eleventh day, the mat- 
ter in the pustules is of a dark yellow colour, the 
head grows less, while the feet and hands begin to 
swell. The secondary fever now makes its appear- 
ance. The pustules break and dry up in scabs and 
crusts, which at last fall off, leaving pits, which suffi- 
ciently mark the cause 



102 Compendium of Domestic Medicine. 

Such are the symptoms of the distinct or mild 
small-pox, but it frequently assumes a more terrible 
shape, in what is called the confluent. In the latter/ 
all the symptoms are more violent from the beginning 
The fever is a typhus, — there is delirium, preceded 
by great anxiety, — heat, — thirst, — vomiting, &c. The 
r-ruption is irregular, coming out on the second day in 
patches, the vesicles of which are flatted in, neither 
does the matter they contain turn to a yellow, but to 
a brown colour Instead of the fever going off on 
the appearance of the eruption, it is increased after 
i\\e fifth day, and continues throughout the complaint 
The face swells in a frightful manner, so as to close 
the eyes, — sometimes putrid symptoms prevail from 
the commencement. 

Causes. Contagion. 

Distinguish it from chicken-gox, which see. 

Treatment. Place the patient in a cool airy 
room, and let him be but lightly covered with bed 
clothes. Purge him every other day with salts, and 
give him twenty or thirty drops of laudanum every 
night The diet should consist of panada, arrow 
root, &c. and his drink consist of lemonade or water. 
If from any cause, the eruption strikes in, put him 
into the warm bath, give a little warm wine-whey, 
or the wine alone, and apply blisters to the feet 
Obstinate vomiting is to be quieted by the effervesc- 
ing draught, with the addition of thirty drops of 
laudanum. 

In the confluent small-pox, the treatment must be 
varied as it inclines more or less to the inflammatory 
or putrid type. If it inclines to the first, act as 
directed for the distinct kind, if to the last, employ 
all those means directed in putrid fever. If the eyes 
are much affected, it will be necessary to bafhe them 
frequently with warm milk, and to smear the lid* 
with some simple ointment 



Itch. 103 



ITCH. 



Symptoms. An eruption of small pimples between 
the fingers, on the wrists, and over the whole body, 
which form matter, and are attended with an intoler- 
able itching. 

Causes. Contagion. 

Treatment. There are several varieties of this 
troublesome complaint, as the rank, watery, pocky, 
scorbutic, &c. A very bad kind of it is contracted 
by touching dogs that have the mange. The remedy 
is sulphur. It should be used internally with cream 
of tartar, so as to purge freely, and at the same time 
be applied externally, in the form of an ointment. 
Equal portions of white vitriol, flour of sulphur, and 
laurel berries, made into a thin liniment with olive 
oil, is highly recommended as a local application. 
The following practice is said to be effectual. Take 
of flour of sulphur two ounces, and mix it well with 
two drachms of nitre, throw the mixture into a warm- 
ing pan containing live coals, and pass the pan be- 
tween the sheets in the usual manner. The patient, 
stripped to his skin, now gets into bed (taking care 
not to let the fumes escape), when the clothes should 
be tucked in all round him. Repeat the process ten 
or twelve times The diet in all cases should be 
very low. 



HERPES. 

Symptoms. Broad itchy spots of a reddish or white 
colour, breaking out in different places, which at last 
run into each other, forming extensive ulcers, — after 
a time they become covered with scales, which fnV, 
off, leaving the surface below red, — while the dis- 
ease heals in one part, it breaks oit m another 



104 Compendium of Domestic Medicine, 

Causes. Want of cleanliness, — low diet, — living 
in low damp situations, — a peculiarity of constitution. 

Treatment. The ointment of the oxide of zinc, 
is a very common application. Washing the parts 
with a solution of corrosive sublimate in water, one 
grain to the ounce, is, however, to be preferred. 
The citrine ointment may also be tried. If these fail, 
apply a strong solution of blue vitriol to the ulcers, 
and take a grain of calomel morning and evening. 
The decoction of sarsaparilla and guaiacum, may be 
used with them. If the disease resists the mercury, 
try Fowler's solution of arsenic, in doses of five drops 
three times a day, to be cautiously increased as 
directed for intermitting fevers. The warm bath 
should never be neglected in cutaneous complaints. 



SCALD HEAD 

Symptoms. Inflammation of the skin of the head 
which ends in a scabby eruption that extends over 
the whole scalp. 

Causes. Want of cleanliness, — putting on the hat, 
— using the comb, or sleeping in the bed of a person 
who has it. 

Treatment. Shave the head close, wash it well 
with warm soap and water, and cover it thickly with 
fresh powdered charcoal. One or two of the pills 
No. 32, should be taken every night, on going to bed. 
The bowels must be kept open by magnesia or Epsom 
salts. If this fails, try the citrine or tar ointment to 
the parts, with a liberal use ol the compound decoc- 
tion of sarsaparilla. The diet should be wholesome 
and nourishing, avoiding spirituous liquors and salted 
meats. The warm bath should not be neglected 



Ring Worm. 105 



RING WORM. 

Sy aiptoms. An eruption running in curved lines, 
—generally in a circle, that itches when rubbed or 
when the body is heated. 

Treatment. Into one ounce of water, throw more 
blue vitriol than it will dissolve, so as to form what 
is technically called a saturated solution. Touching 
the ulcerated parts with this liquid several times 
through the day, will alone frequently cure it. If 
this fails, apply the citrine or tar ointments. In very 
obstinate cases, recourse may be had to the pills No. 
32, or to the usual doses of Fowler's solution. If it 
affects the head, shave it. In this as well as all other 
diseases of the skin, the greatest cleanliness is ne- 
cessary. 



NETTLE-RASH. 

Symptoms. An eruption similar to that caused by 
the stinging of nettles, whence its name. On rub- 
bing the skin which itches, the eruption will sud- 
denly appear, remain for a moment and then vanish, 
breaking out in some other spot. The parts affected 
are swelled, — at one time presenting the appearance 
of welts as from the stroke of a whip-lash, and at an- 
other, that of white solid bumps. 

Causes. Supposed to be some irritating matter in 
the stomach or bowels. 

Treatment. A few doses of Epsom salts, and a 
little attention to the diet, which should be mild, are 
generally sufficient to remove it. If it proceed from 
eating poisonous fish, on any unwholesome food, tak? 
an emetic, &"c. as directed in such cases. A 
bath in a very mild solution of washing soda 
will allay the itching. 



106 Compendium of Domestic Medicine, 

BLOTCHED FACE. 

Symptoms. An eruption of hard, distinct tubercl es 
or pimples, generally appearing on the face, but some- 
limes on the neck, breast and shoulders. 

Causes. A peculiarity of constitution, — irregu- 
larity or excess in eating or drinking. 

Treatment. There are a great many varieties of 
this affection, some of which have been separately 
treated of by Willan and other writers on diseases 
df the skin, to whom I would refer any one w T ho is 
particularly interested therein. Notwithstanding all 
ihat has been said on the subject, there is no disease 
wore difficult to get rid of than this. Where it arises 
from supuressed perspiration, high seasoned food, or 
intemperctnce, it may indeed be relieved by the warm 
bath, by sweating, purging, and a low diet; but when 
it exists in persons who have always led temperate 
lives, and in whom it seems constitutional, medicine 
nas but little effect on it. In all cases, however, the 
following plan may be adopted : take a dose of Epsom 
salts twice 01 thrice a week, use the warm bath daily, 
live on plain, mild food, and drink nothing but water. 
If after a fair trial of several months, this should not 
succeed, try Fowler's solution, or the pills No. 32. 
with the decoction of guaiacum and sarsaparilla. 
The various cosmetics and astringent applications 
recommended for these affections, are always preju- 
dicial, for although they sometimes repress the erup- 
tion, they occasion more severe and dangerous com- 
plaints. 



SCURVY 

Symptoms. Bleeding of the gums, — teeth loose, — 

spots of various colours on the skin, generally livid, 

debility, — countenance pale and bloated, — pulse 



Scurvy. 107 

small, quick, and intermitting. In its advanced stage 
the joints swell, and blood bursts out from different 
parts of the body. 

Causes. A long exposure to cold moist air, — a diei 
consisting exclusively of salted animal food, — want 
of wholesome nourishment. 

Treatment. Remove the patient to a new and 
healthy situation, where the air is dry and pure ; give 
him plenty of fresh vegetables, such as spinage, let- 
tuce, beets, carrots, and scurvy-grass. A small pro- 
portion of fresh animal food should be taken with 
them. This, with oranges, lemons and sugar, or 
lemonade, spruce beer with wine and water, are 
generally sufficient to cure the complaint. The nitric 
vinegar* is strongly recommended for the same pur- 
pose. If there is much pain in the bowels, laudanum 
must be used to relieve it. If the breathing is diffi- 
cult, or there is much pain in the breast, apply a blis- 
ter to it, for on no account should blood be drawn in 
scurvy. A tea spoonful of charcoal well mixed with 
half a pint of vinegar, forms an excellent gargle to 
clean the gums and ulcers in the mouth. Those on 
the body may be washed with the same, or lemon 
juice, pure, or mixed with water. The yeast or char- 
coal poultice, may also be applied to them with ad- 
vantage. To restore the tone of the system, recourse 
must be had to the Peruvian bark, with the elixir of 
vitriol, the muriated tincture of iron, exercise, &c. &c 



* It is made in the following manner. Dissolve 
three or four ounces of nitre (saltpetre) in one quart 
of vinegar. The dose is from half an ounce to an 
ounce. If the strength of it occasions any inconve- 
nience, add a l'ttle water, or diminish the quantity 
of the dose. 



108 Compendium of Domestic Medicine. 

OF TUMOURS 

By the word tumour is meant a swelling of* any 
part of the body. They are of different kinds, ariso 
from various causes, and are more or less dangerous 
according to the nature of their contents and the spot 
they occupy. 



OF RUPTURES. 

Ruptures are tumours caused by the protrusion of 
a part of the bowels through certain natural openings. 
They are divided into reducible, irreducible, and 
strangulated. They mostly occur in men in the groin 
and bag. 

Causes. Straining in any way, as at stool , — vomit- 
ing, — lifting heavy weights, — violent exercise, as 
jumping, running, &c. — a natural weakness of the 
parts. 



REDUCIBLE RUPTURES. 

Symptoms. A small swelling, free from pain, and 
generally soil;, the colour of the skin over it remain- 
ing unaltered. While standing up, the swelling in- 
creases, on lying down, it decreases, the patient being 
able to return the parts himself, while in that position. 
The swelling is also increased by coughing, sneezing, 
or straining as if at stool. If he is flatulent, a rum- 
bling sensation may be felt in it. 

Treatment. The patient should place himself on 
his back, with his head and shoulders a little ele- 
vated, draw up his knees to his belly, and (if in thii 
position, the parts do not return of themselves) en- 
deavour to push or knead them up into the belly 



Reducible Ruptures. 109 

through the opening at which they come out, and 
which, if the tumour be in the groin or bag, is an oval 
ring or slit, in the groin, at the precise spot where 
the swelling first appeared. When this is effected, 
he should remain quiet until a truss can be procured, 
the spring of which must be passed round his body 
the pad be applied directly over the spot just men- 
tioned, and held there with one hand, while the other 
passes the strap into the buckle and draws it suffi- 
ciently tighu Having done this, he should get up 
and walk about. If the swelling no longer appears, 
the truss is properly applied, if otherwise, take it off, 
return the parts as before and apply it again ; when, 
if on rising, walking about, slightly coughing, &c. the 
parts are found to be well kept up, he may resume 
his ordinary business. The truss should be worn 
nigh i and day, as long as he lives. 



IRREDUCIBLE RUPTURES. 

Symptoms. A rupture in which there is no pain, 
yet that cannot be returned into the belly, caused by 
an increased bulk of the parts, or their having formea 
adhesions, or grown fast to adjoining parts. 

Treatment. A rupture thus situated must be left 
to itself. The patient should be extremely cautious 
in his diet, and in avoiding costiveness, by the use 
of clysters, or if necessary, laxative medicines. He 
should also be very careful to protect the tumour 
from blows, always recollecting that it is in danger 
of strangulation. 



STRANGULATED RUPTURES. 

Symptoms. The first mark of a rupture being 
strangulated, or of pressure being made on it, is cos- 



110 Compendium of Domestic Medicine. 

tiveness. The tumour, which before was insensible 
becomes painful, the pain being most severe at the 
soot where the strangulation or stricture exists, and 
extending from thence across the belly, which be- 
comes swollen and hard. The pain resembles that 
which the patient would suppose to arise if a cord 
was drawn tightly across it. The pain continues to 
increase, and is augmented by pressure ; sneezing, 
coughing, nausea and vomiting, first of the contents 
of the stomach, and afterwards of the intestines ensue, 
—great anxiety, — restlessness, and a quick hard pulse. 
Hiccups, — cold clammy sweats, — weakened respira- 
tion, and a pulse so feeble as hardly to be perceived, 
announce the approach or presence of mortification. 

Treatment. Lose not a moment in sending for 
the best medical aid that may be within reach. In 
the mean time, having placed the patient as directed 
for reducible ruptures, apply both hands on the tumour 
with gentle, but gradually increasing pressure, or 
grasp the tumour gently but steadily with one hand, 
while with the fingers ofthe other you endeavour to 
knead or push up the parts nearest the ring in the 
groin, applying the pressure in the same course the 
parts have taken in their descent. If this fails, seize 
the tumour between the finger and thumb of the left 
hand, close to where it enters the belly, and carry 
them downwards, with a moderate pressure, so as to 
dislodge any excrement which may be there, while 
with the ri b ht you endeavour to push in the gut. 

If you cannot succeed in two or three attempts, 
place the patient in a warm bath and try it again. If 
still foiled (you have no time to waste in unavailing 
attempts), cover the tumour with pounded ice, snow, 
or any very cold application. Should this fail, let 
the patient inhale ether or chloroform to perfect 
narcotism, and when thoroughly under the anes- 
thetic, seize that moment to return the parts, as 
before directed. 

Should the rupture still remain irreducible, there 
are but two resources left, the tobacco clyster, and 
an operation One half of the clyster should be in- 



Strangulated Rupture*. Ill 

jected ; if it occasions sickness and a relaxation of the 
parts, endeavour to return them: if the first half does 
not produce these effects, throw up the remainder of 
it, and when relaxation comes on, endeavour, as be- 
fore, to push up the gut. As regards the operation 
no one should ever attempt it but a surgeon. Large 
doses of laudanum allay vomiting, and are otherwise 
beneficial; in all cases of this kind, they should never 
by omitted. 



Ruptures are liable to be confounded with some 
other diseases, as dropsy of the bag, enlarged sper- 
matic vein, &c. The modes of distinguishing them 
have already been pointed out, although it must be 
confessed that with respect to the latter, considerable 
difficulty exists. If the disease is a rupture, by plac- 
ing the patient on his back, returning the tumour and 
holding the fingers firmly over the opening, and then 
desiring him to rise, the swelling will not appear. It', 
on the contrary, it is an enlarged spermatic vein, it 
will be found to be greater than ever. The latter 
has also a peculiar ropy feel, as if a bundle of cords 
were in the bag. 



ANEURISM. 

Symptoms. A small tumour without pain or red 
ness, attended by a peculiar throbbing, — it disappears 
on pressure, and returns the moment it is removed. 
As the tumour increases in size, the throbbing or 
beating of the artery grows less perceptible. It is 
generally found in the ham, thigh, neck, groin and 
arm. It is divided into true and false. 

Causes of the true are unknown, those of the false 
are a wound or rupture of an artery. 

Distinguish it by the beating or throbbing, which 



112 Compendium of Domestic Medicine. 

is diminished by pressing on the artery above the 
tumour, and by the latter disappearing on pressure 
and returning when it is removed. 

Treatment. In the early stage, apply a soft and 
elastic cushion to the tumour, and bind it tightly over 
it by a bandage. The diet should in all cases be 
extremely low, just sufficient to preserve life, and no 
more. If the patient is of a full habit, it would be 
well to reduce. This plan steadily and vigorously 
pursued for a long time, has sometimes effected com- 
plete cures. There is nothing, however, but an 
operation that can be depended on, wherefore, as 
soon as any swelling of this nature is perceived, no 
time should be lost in procuring surgical assistance. 
If the tumour is left to itself) it will finally burst, and 
death be the inevitable consequence. 



FLESHY TUMOURS. 

Symptoms. Small warty projections, which, as 
they increase in size, drag down the skin from the 
neighbouring parts, which forms a kind of stem or 
foot-stalk on which the tumour hangs. They are 
hard, full of vessels, and are neither painful nor in- 
flamed. 

Treatment. When very small, they may be fre- 
quently touched with caustic, which will destroy 
mem. If large, the ligature or knife must be em- 
ployed, for which purpose have recourse to a surgeon. 



STEATOMATOUS TUMOURS. 

Symptoms. A small, doughy swelling, which 
gradually increases, and sometimes grows to an 
enormous size. It is soft and free from pain, — the 
colour of the skin eraaining unaltered. 



Steatomatous Tumours. 113 

Treatment. These tumours, technically called 
steatomatous,* are merely inconvenient from their 
bulk. They can only be removed by the ligature o? 
knife, for which purpose apply to a surgeon. 



ENCYSTED TUMOURS. 

Symptoms. A distinct, hard, circumscribed swell- 
ing, gradually growing larger until a slight inflam- 
mation comes on, when it becomes a little painful, 
soon after which, a fluctuation is distinctly to be per- 
ceived. As it progresses the vessels become en- 
larged, — it seldom exceeds the size of an egg. 

Distinguish it from an abscess by the absence of 
pain and inflammation. 

Treatment. Pass a seton through the tumour 
when matter is formed, or apply to a surgeon to dis- 
sect it out. 



GANGLION. 

Symptoms. A small, movable, elastic swelling, 
with little or no pain, or alteration in the skin, situ- 
ated under or between tendons or sinews, and gene- 
rally near to a joint, — it sometimes hinders the mo 
tions of the part. 

Causes. The collection of a fluid within the sheath 
of a tendon. 

Treatment. Apply pressure, blisters, or frictions 
of strong camphorated mercurial ointment to the tu- 
mour. If these are of no avail, make a small punc- 
ture in it with the point of a sharp lancet, let out its 

* P rom a Greek word which means suet, the con- 
tents of the tumour rersemblins that substance. 
H 



114 Compendium of Domestic Medicine. 

contents and apply pressure to the part, so as to make 
the two sides of the sack or bag grow together. 



BOILS. 

Symptoms. A hard, circumscribed, inflamed and 
very painful tumour, of a conical shape, seldom ex- 
ceeding in size a pigeon's egg. 

Treatment. If the patient is of a full habit, bl eed 
and purge him with Epsom salts. A soft poultice of 
warm bread and milk, or rye meal, should always be 
applied to the boil, and frequently changed. If the 
pain is excessive, a tea spoonful of laudanum may be 
mixed with each one. In a few days matter will be 
formed, when it may be let out with a sharp lancet 



CARBUNCLE. 

A deeply seated, hard, immovable and circum- 
scribed tumour, which appears generally on the back, 
shoulders, &c. About the middle it is of a dark red 
or purple colour, being much paler or mottled round 
its edges. It is attended with an intolerable itching 
and burning pain, and at last becomes a kind of 
sloughing ulcer. 

Treatment. This will depend upon the state of 
the constitution. Most generally there is great weak- 
ness, in which case, the diet must be generous. 
Bark, with the elixir of vitriol and opium to relieve 
(he pain, are to be frequently employed. As a local 
remedy, a blister ranks very high. It should be 
placed directly on the part. After being cut, it may 
be succeeded by a basilicon plaster. A modern writer 
strongly recommends the solution of arsenic, as a local 
remedy in this disease. Pledgets of linen dipped in 
the liquor, are to be laid on the swelling, and fre 



Carbuncle. 115 



quently renewed. When matter begins to form, 
apply a bread and milk poultice, and treat it in every 
respect as a common ulcer. 



WHITLOW, OR I ELON. 

Symptoms. An inflamed tumour at the end oi tne 
linger. It is of three kinds. The first is situated im- 
mediately under the skin, around the nail. The 
second in the cellular membrane, the pain and swell- 
ing of which are much greater than in the first, and 
the matter much longer in forming. The third lies 
under the sheath or covering of the tendons of the 
fingers, and is infinitely more violent, painful and 
dangerous, than either of the others. 

Treatment. If of the first description, open the 
little abscess with a needle and let out the matter, 
which should be prevented from forming, if possible, 
by bathing the part with camphorated spirits. The 
second shouJd be dispersed by purging, and by leeches 
and blisters. If the inflammation is not reduced by 
these means, with a very sharp penknife, make an 
early and free incision in the sides of the last joint 
of the finger down to the hone. Suffer the blood to 
run for a few minutes, and then treat it as a common 
cut The same practice should be followed with 
regard to the third. 



PILES. 



Symptoms. A pain in the fundament when gome 
to stool, — on examination small tumours are perceived 
to project beyond its verge. They are of two kinds, 
the blind and bleeding. They may also be internal 
and external. 



116 Compendium of Domestic Medicine. 

Causes. Costiveness, — sedentary habits, — aloetic 
purgatives, — riding on horseback. 



BLIND PILEfe. 

Treatment. A diet of rye mush and milk, strictly 
adhered to for a length of time, will very frequently 
cure the disease. If they project, are swelled and 
painful, apply twenty or thirty leeches to them, and 
cold applications. The common gall ointment is a 
very soothing application. Balsam copaiva in doses 
sufficiently large to purge freely, is also highly re- 
commended. A radical cure, however, is only to be 
sought for in the knife or ligature, for which apply to 
a surgeon. If the pain is very great, laudanum may 
be taken to ease it. 



BLEEDING PILES. 

Treatment. If the bleeding is considerable, inject 
a solution of alum or a decoction of oak bark, or make 
pressure upon the vessels by introducing a sheep's 
gut, tied at one end, into the fundament, and then 
filling it with any astringent fluid by a clyster pipe. 
This evacuation is sometimes salutary, arid it often 
requires much judgment to know if it should be stop- 
ped or not. 



OF ABSCESS. 

Symptoms. The formation of matter under the 
skin, or in any part of the body, preceded by inflam- 
mation, and marked by a dull heavy weight, — by the 
pain booming more acute and darting, — by a pecu- 



Abscess. 117 

liar throbbing, — by the swelling becoming more ele- 
vated and soft to the touch. If the tumour is not 
opened it bursts. 

Causes. Inflammation from injuries, or stimulus 
of any kind. 

Treatment. Apply a soft and warm bread and 
milk, or linseed poultice to the part s and endeavour 
to hasten the formation of matter. When this is evi- 
dent, let it out with a sharp lancet. If the patient is 
weak, let him have a generous diet with wine, por- 
ter bark, &c. 



PSOAS ABSCESS. 

Symptoms. A weakness across the loins accom- 
panied by a dull pain. After a while, the pain shifts 
from the back to the thigh and hip, becoming more 
darting and severe. The glands in the groin swell, 
and at last a soft tumour is perceived at the lower 
edge of the groin, or by the side of the fundament, — 
the swelling increases to a large size, and sometimes 
extends itself down the thigh. 

Causes. Scrofula, — straining of the back, — blows, 
&c. 

Distinguish it from a rupture, by the preceding 
pain in the loins, and by the fluctuation. 

Treatment. In the early stage, bleed and purge 
the patient, keep him on a low diet, and apply a large 
blister over the lower part of the back. Confine- 
ment in bed is absolutely necessary. When matter 
is formed, make an opening into the tumour in the 
following manner — push a sharp lancet first through 
the skin, then obliquely upwards under it, and then 
by depressing the point pierce the swelling itself. 
In this way the abscess is opened without the danger 
that attends wounds of large cavities. If it is small, 
the whole of the matter may be allowed to flow away 
at once; if large, after drawing a pint, close the wound 



118 Compendium of Domestic Medicine. 

for a few hours and then finish the operation. The 
lips of the wound must be kept together by sticking 
plaster. As there are many vessels of importance in 
the groin, care must be taken to avoid wounding 
them, and if a surgeon can be had, he should always 
be applied to for this purpose. The disease is said 
to have been cured by blistering the tumour, and 
keeping it open with the savin ointment. ■ 



OF FISTULA 

Symptoms. An abscess or ulcer in the neighbour- 
hood of the fundament, preceded by an inflamed hard 
swelling, which gives much pain. If there is no 
communication between the gut and the sore, it is 
called an incomplete, if there is, a complete fistula. 

Treatment. As the tumour is often taken for 
piles, attention should be paid to distinguish them. 
In all cases apply forty or fifty leeches to the part, 
keep the bowels perfectly loose by a diet of rye 
mush, and confine the patient to his bed. If, how- 
ever, the formation of matter cannot be hindered, 
the swelling must be opened early and a poultice 
applied to it, when the disease occasionally heals 
like any other sore, but nine times out of ten it forms 
a callous winding abscess, through which (if it is 
complete) excrement, &c. often pass. When it ar- 
rives at this point, nothing but an operation can 
ever be of any service. 

There is another species of fistulous opening, 
which follows the obstruction, caused by strictures. 
&c. in the urinary passage. The water not being 
able to flow through the natural canal, makes its 
way out between the bag and the fundament, con- 
stituting what is called fistula in perineo. It may 
almost be called an incurable disease; at all events 
none but a surgeon can do any thing to relieve <L 



Ulcers. 119 



OF ULCERS. 

• By ulcers are meant holes or sores in the skin 
and flesh, which discharge matter. They are 
divided into inflamed, fungous, sloughing, and 
indolent, ulcers in the neighbourhood of carious 
bone, and those attended by a peculiar dis- 
eased action. 



INFLAMED ULCER. 

Symptoms. The margin of the sore is ragged, 
—the skin ending in a sharp edge around it. 
The neighbouring parts are red, swelled and 
painful, the bottom of the ulcer is uneven and 
covered with a white spongy substance. In 
place of a healthy yellow matter, it discharges 
a thin fluid; the surface of it bleeds on the 
slightest touch. 

Treatment. Keep affected part elevated so 
that it is on a level with the body, and amend 
the general health. For local treatment, put two 
teaspoonfuls of the 50 per cent, solution of 
carbolic acid into a pint of water that has been 
previously sterilized by boiling, and wash the 
ulcer, then dry it with plegets of aseptic cot- 
ton, dust over it a complete layer of boric acid, 
cover it with aseptic gauze, and wrap with 
bandage. To remove dressing, unwind band- 
age, cut away all gauze that is free, and then 
soak loose all that is adherent, in a carbolized 
solution prepared as above, and dress as be- 
fore. Renew dressing every day to every fourth 
day according to the discharge and the way 
dressings are soiled. By following these direc- 
tions, and never using any ointments, or greasy 
condiments to come in contact with the ulcer, 
it will generally improve rapidly, and the 
fungous and indolent varieties of ulcers will 
rarely be met with. 



120 Compendium of Domestic Medicine. 



UNGOUS ULCERS. 

Symptoms. The presence of large round, 
granulations rising above the level of the ad- 
joining parts, or what is commonly called 
proud flesh, marks this species of ulcer. 

Treatment. After washing and drying the 
same as in inflamed ulcers, touch the granula- 
tion with caustic, and then apply the same 
dressing as for inflamed ulcers. 



SLOUGHING ULCER. 

Symptoms. The death of parts of an ulcer 
which mortify and fall off, — generally attended 
by fever and pain. 

Treatment. The diet should be generous, 
and take some alterative tonic, such as 20 drops 
of the syrup of the iodide of iron, in water, 
three times daily at meal time. Wash and 
dress as in inflamed ulcers, removing all the 
dead portions whenever possible. 



INDOLENT ULCER. 

Symptoms. The edges of the skin are thick, 
raised, smooth and shining. The points of new 
flesh are glossy, and the appearance of the 
whole ulcer is that of an old one in which the 
healing process is at a stand. 

Treatment. Follow the directions for fung- 
ous ulcers, touching the caustic to all the in- 
dolent parts, then waiting several days or un- 
til the ulcer becomes indolent again, when it 
should be touched as before. Take the syrup 
of the iodide of iron. 



Carious Ulcer. 121 



CAEIOUS ULCER. 

Symptoms. Ulcers situated over or near 
carious (or dead) bone, they are thereby pre- 
vented from healing-, — they frequently pene- 
trate deep into the parts, forming a canal with 
hard and indolent sides, that discharges an 
offensive unhealthy matter. 

Treatment. Sometimes the dead bone may 
be thrown off and come away itself; but there 
is always danger of the caries spreading into 
the healthy bone and doing extensive damage, 
and for this reason it is advisable to have a 
surgeon remove all the diseased bone, at once, 
which has the advantage of cutting short the 
patient's suffering and having the ulcer healed 
within a few days. 



SCORBUTIC ULCER. 

See Scurvey. 



SCROFULUS ULCER. 

See Scrofula. 



VENEREAL ULCER. 

See Syphilis. 



122 Compendium of Domestic Medicine. 



CHAPTER III. 

Of Accident*. 

GENERAL DIRECTIONS. 

Whenever, a blow has been inflicted, whether by 
being thrown from a horse, — out of a carriage, — by 
falling from a height, or in any other way, the first 
thing is to examine for any bruised or wounded 
places or broken bones, and apply ice or cold water 
cloths over the parts. This rule admits of but one 
exception, and that is, when the violence has been 
so great as nearly to extinguish all the powers of life, 
in which case it is proper to wait for symptoms of 
returning animation. To hasten these, a little wine 
and water, or other stimulus may be given. 

If, in consequence of a broken bone or other inj ury, 
the patient is unable to walk, take a door from its 
hinges, lay him carefully on it, and have him carried 
by assistants to the nearest house. If no door or sofa 
can be procured, two boards, sufficiently long and 
broad, should be nailed to two cross pieces, the ends 
of which must project about a foot, so as to form han- 
dles. If in the woods, or where no boards can be 
procured, a litter may be formed from the branches 
of trees. In this way a hand-barrow may be con- 
structed in a few minutes, on which the sufferer may 
be properly carried. 

If he has been wounded and bleeds, the bleeding 
must be stopped before he is removed. 

Having reached a house, lay him on a bed, and 
indr3ss him with care and gentleness. If any diifi- 




MODE OF BANDAGING. 



General Directions, 123 

culty arises in getting off his coat or pantaloons, rip 
up the seams, rather than use force. This being 
done, proceed to ascertain the nature of the injury. 

This may be either simple or compound; that is, it 
•nay be a contusion or bruise, a wound, fracture or 
dislocation, or it may be two or all of them united in 
one or several parts. 

A contusion is the necessary consequence of 
every blow, and is known by the swelling and dis- 
coloration of the skin. 

Wounds are self-evident. 

Fractures are known by the sudden and severe 
pain, — by the misshapen appearance of the Jimb, — 
sometimes, by its being shortened, — by the patient 
being unable to move it without excruciating pain, — 
but most certainly, by grasping the limb above and 
below the spot where the fracture is supposed to 
exist, and twisting it different ways, when a grating 
will be felt, occasioned by the broken ends of the 
bone rubbing against each other. If the swelling, 
however, is very great, this experiment should not 
be made until it is reduced. 

Dislocations, or bones being out of joint, are 
Imown by the deformity of the joint when compared 
with its fellow, — by the pain and inability to move 
the limb, — by its being longer or shorter than usual, 
and by the impossibility of moving it in particular 
directions. 



OF CONTUSION. 

if slight, bathe the part frequently with cold vine- 
gar and water for a few hours, and then rub it well 
with brandy, or spirits of any kind. Should it be 
very great, or so as to have affected the whole body, 
which may be known by a general soreness, bleed 
and purge the patient, and confine him to a diet of 
rice water, lemonade, panada, &c. If fever comes 



124 Compendium of Domestic Medicine. 

on, repeat the bleeding, purging, &c. In all cases of 
this nature, be sure the water is regularly evacuated, 
for it sometimes happens that in consequence of the 
nerves of the bladder being palsied by the blow, the 
patient feels no desire to pass it, though the bladder 
be full. If a suppression ensues, pass a catheter, if 
possible, or procure assistance for that purpose. 



OF SPRAINS. 

Plunge the part sprained into very cold water, and 
hold it there as long at a time as you can bear it — 
for several hours — then rub it well with camphorated 
spirits If the accident has happened to a joint, as 
in the ankle, and it remains weak, pour cold water 
on it from the spout of a tea kettle, held at a distance, 
several times in the day. The most serious effect, 
however, resulting from contusion, is when the blow 
is applied to the head, producing either concussion 
or compression of the brain. 



CONCUSSION OF THE BRAIN. 

Symptoms. The patient is stunned,— his 
breathing- is slow, drowsiness, — stupidity,— the 
pupil of the eye rather contracted, — vomiting. 
After a time he recovers. 

Treatment. Confine the patient in a quiet 
room, — apply ice bags to his head, — and open 
his bowels with liquid citrate of magnesia or 
epsom salts. He should be kept in a quite 
situation, and every measure taken to prevent 
inflammation of the brain. 

For inflammation of the brain see cerebro- 
spinal meningitis. 



Compression of the Brain. 12c 



COMPRESSION OF THE BRAIN 

Symptoms. Loss of sense and motion, — slow, noisy 
and laborious breathing, — pulse slow and irregular, 
— the muscles relaxed, as in a person just dead, — the 
pupil of the eye enlarged and will not contract even 
by a strong light, — the patient lies like one in an 
apoplectic fit, and cannot be roused. 

Treatment. Open a vein and draw off sixteen 
or twenty ounces of blood, shave the head, and if 
possible, procure surgical assistance without delay, 
as there is nothing but an operation that can be of 
any avail. 



OF WOUNDS. 

Wounds are of three kinds, viz. incised, puncturea 
and contused, — among the latter are included gun- 
shot wounds. The first step in all wounds, is 

TO STOP THE BLEEDING. 

If the flow of blood is but trifling, draw the edges 
of the wound together with your hand, and hold them 
in that position some time, when it will frequently 
stop. If, on the contrary, it is large, of a bright red 
colour, flowing in spirts or with a jerk, clap your fin- 
ger on the spot it springs from, and hold it there with 
a firm pressure, while you direct some one to pass a 
handkerchief round the limb (supposing the wound 
to be in one) above the cut, and to tie its two ends to- 
gether in a hard knot. A cane, whip-handle or stick 
of any kind, must now be passed under the knot (be- 
tween the upper surface of the limb and the hand- 
kerchief) and turned round and round until the stick 
is brought down to the thigh, so as to make the hand- 
kerchief encircle it with considerable lightness. You 
ttiay then take offvour finger: if the blood still flows 



126 Compendium of Domestic Medicine. 

tighten the handkerchief by a turn or two of the stick, 
until it ceases. The patient may now be removed 
'taking care to secure the stick in its position) with- 
out running any risk of bleeding to death by the way. 

As this apparatus cannot be left on for any length 
of time, without destroying the life of the parts, en- 
deavour as soon as possible to secure the bleeding 
vessels, and take it off Having waxed together 
three or four threads of a sufficient length, cut the 
ligature they form, into as many pieces as you think 
there are vessels to be taken up, each piece being 
about a foot long Wash the parts with warm water, 
and then with a sharp hook, or a slender pair of pin- 
cere in your hand, fix your eye steadfastly upon the 
wound, and direct the handkerchief to be relaxed by 
a turn or two of the stick; you will now see the 
mouth of the artery from which the blood prings, 
seize it with your hook or pincers, draw it a little 
out, while some one passes a ligature round it and 
ties it up tight, with a double knot. In this way take 
up in succession every bleeding vessel you can see 
or get hold of. 

If the wound is too high up in a limb to apply the 
handkerchief, do not lose your presence of mind,* the 
bleeding can still be commanded. If it is the thigJi, 
press f.rmly in the groin, — if in the arm, with the 
hand-end or ring of a common door key, make pressure 
above the collar bone, and about its middle against 
the first rib which lies under it. The pressure is to 
oe continued until assistance is procured, and the 
vessel tied up. 

If the wound is on the head, press your finger firmly 

* A little practice on himself or others, would soon 
enable any one to compress the great arteries in these 
f\vo situations. And it is well worth the time spent 
in doing so. Many a man has bled to death before a 
surgeon could be procured, although surrounded with 
persons who, by the simple process above mentioned 
might have preserved him 




MODE OF BANDAGING, 



W( unds. 127 



on it, until a compress can be brought, which must 
be bound firmly over the artery by a bandage. If 
the wound is in the face, or so situated that pressure 
cannot be effectually made, or you cannot get hold 
of the vessel, and the blood flows fast, ph.ce a piece 
of ice direcihj over the wound, and let it remain there 
till the blood coagulates, when it may be removed and 
a compress and bandage be applied 



INCISED WOUNDS. 

By an incised wound, is meant a clean cut. 
Attempt to stop the bleeding, wash away all 
dirt, and cleanse the wound perfectly clean 
with water which has been sterilized by boil- 
ing. If possible, add some antiseptic to this 
sterilized water, such as two teaspoonfuls of 
the 50 per cent, solution of carbolic acid to 
each pint of water; or some boric acid or cor- 
rosive sublimate. If the wound is too trivial to 
require suturing, cover with aseptic or anti- 
septic gauze and bandage. If suturing is neces- 
sary, summon a surgeon. Suturing is per- 
formed with cat-gut, kangaroo tendon, or silk, 
specially prepared for surgeon's use. After the 
wound is sutured, cover with gauze and band- 
age. By observing the strictest cleanliness, and 
letting nothing come in contact with the wound, 
except what has been sterilized, or made free 
from germs by antiseptics, there is usually a 
satisfactory healing, and very slight danger of 
blood poisoning, lock jaw, etc. 

From what has been said, it must be evident 
that in all wounds, after arresting the flow of 



128 Compendium of Domestic Medicine. 

blood and cleansing the parts, if necessary, 
the great indication is to bring their sides into 
contact throughout their whole depth, in order 
that they may grow together as quickly as 
possible, and without the intervention of mat- 
ter. To obtain this very desirable result, in 
addition to the means already mentioned, 
there are two things to be attended to, the po- 
sition of the patient and the application of a 
bandage. The position of the patient should 
be such as will relax the skin and muscles of 
the part wounded, thereby diminishing their 
tendency to separate. 

A common bandage of a proper width, passed 
over the compresses moderately tight, not only 
serves to keep them in their place, but also 
tends by its pressure to forward the great 
object already mentioned. If, however, the 
wound is so extensive and painful that the 
limb or body of the patient cannot be raised 
for the purpose of applying or removing it, 
the best way is to spread the two ends of one 
or two strips of linen or leather with sticking 
plaster, which may be applied in place of the 
bandage, as follows: attach one end of a strip 
to the sound skin, at a short distance from the 
compress, over which it is to be drawn with 
moderate firmness, and secured in a similiar 
manner on its opposite side. A second or third 
may, if necessary, be added in the same way. 

In all wounds, if violent inflammation comes 
on, reduce it by cold, purging, &c. ; but if there 
is any reason to fear locked-jaw, give wine, 
porter, brandy, opium, and a generous diet. 



Punctured Wounds. 129 



PUNCTURED WOUNDS. 

These are caused by sharp pointed instru- 
ments, as needles, awls, nails, &c. Having 
stopped the bleeding, withdraw any foreign 
body, as part of a needle, splinters, bits of 
glass, &c. that may be in it, provided it can be 
done easily; and if enlarging the wound a little 
will enable you to succeed in this, do so. 
Though it is not always necessary to enlarge 
wounds of this nature, yet in hot iveather it is a 
mark of precaution, which should never be 
omitted. As soon as this is done, pour a little 
turpentine into the wound, or touch it with 
caustic. This practice may prevent locked-jaw, 
which is but too frequent a consequence of 
wounds of this description. Cover the part 
with antiseptic dressings, as in incised 
wounds. 



CONTUSED WOUNDS. 

Wounds of this nature are caused by round 
or blunt bodies, as musket balls, clubs, stones, 
<fcc. They are in general attended by but little 
bleeding; if, however, there should be any, it 
must be stopped. If it arises from a ball 
which can be easily found and withdrawn, it is 
proper to do so, as well as any piece of the 
clothing, &c. that may be in it; or if the ball 
can be distinctly felt directly under the skin, 
make an incision across it and take it out, but 
never allow of any poking in the wound to 
search for such things. Should the inflamma- 



130 Compendium of Domestic Medicine. 

tion be great, apply ice bladder. Pain may be 
relieved by laudanam, and if the part3 assume 
a dark look, threatening a mortification, cover 
them with a blister. 

If the wound is much torn, wash the parts 
very nicely with warm water, and then (having 
secured every bleeding vessel) lay them all 
down in as natural a position as you can, 
drawing their edges gently together, or as 
much so as possible by stitches, if necessary. 



POISONED WOUNDS, FROM BITES OF MAD 
DOGS, RATTLE-SNAKES, &c. 

The instant a person is bitten either by a mad dog, 
rattle-snake, or any rabid animal, or reptile, he should 
apply a ligature, by means of the stick (see directions 
to stop bleeding, ante p. 125), above the wound, as 
tightly as he can well bear it, and without hesitation 
jr delay cut out the parts bitten, taking along with 
them a portion of the surrounding sound flesh. The 
wound should then be freely touched with caustic, 
or have turpentine poured into it. By these means 
inflammation will be excited, and suppuration follow 
which may prevent the usual dreadful consequences 
of such accidents. As soon as the parts are cut out, 
take off the ligature. 

Should the patient be too timid to allow the use ot 
the knife, burn the wound \ery freely with caustic, 
and place in it a tuft of tow or cotton, well moistened 
with turpentine. The discharge of matter that fol 
lows, should be kept up for some time, ^he only 
reasonable chance of safety, is found in the above 
plan, all the vegetable and mineral productions tha 
have been hitherto recommenced as internal rem? 
\lies being of verv doubtful, if of any efficacy 



Stings. 13i 



STINGS OF BEES AND WASPS, BITES OF 
MOSQUITOS, &c. 

Nothing relieves the pain arising from the sting of 
a hornet, bee, or wasp, so soon as plunging the part 
in extremely cold water, and holding it there for 
some time. A cold lead-water poultice is also a very- 
soothing application. If a number of these insects 
have attacked you at once, and the parts stung are 
much swollen, lose some blood, and take a dose of 
salts. 

Mosquito-bites maybe treated in the same man- 
ner, although I have found a solution of hartshorn 
ami water, made very strong, the most speedy and 
effectual in relieving the pain. Camphorated spirits, 
vinegar, &c. may also be used for the same purpose 



WOUNDS OF THE LIMBS, &c. 

OF THE EAR, NOSE, &C. 

Wash the parts clean, and draw the edges of the 
wound together by as many stitches as are necessary. 
If the part is even completely separated, and has been 
trodden under foot, by washing it in warm water, and 
placing it accurately m its proper place by the same 
means, it may still adhere. 

OF THE SCALP. 

In all wounds of the scalp it is necessary to shave 
off the hair. When this is done, wash the parts well, 
and draw the edges of the wound together with stick- 
ing plaster. If it has been violently torn up in seve- 
ral pieces, wash and lay them all down on the skull 
again, drawing their edges as nearly together as possi 



132 Compendium of Domestic Medicine. 

ble by sticking plaster, or if necessary, by stitches. 
Cover the whole with a soft compress of cotton 
and antiseptic gauze. 

OF THE THROAT. 

Seize and tie up every bleeding vessel you can get 
hold of. If the wind pipe is cut only partly through, 
secure it with sticking plaster; if it is completely 
divided, bring its edges together by stitches, taking 
care to pass the needle through the loose membrane 
that covers the wind pipe, and not through the wind 
pipe itself. The head should be bent on the breast, 
and secured by bolsters and bandages in that position, 
to favour the approximation of the edges of the wound. 

OF THE CHEST 

If it is a simple incised wound, draw the edges of 
it together by sticking plaster, cover it with a com- 
press of linen, and pass a bandage round the chest. 
The patient is to be confined to his bed, kept on a 
very low diet, and to be bled and purged, in order to 
prevent inflammation. If the latter comes on, reduce 
it by copious and frequent bleedings. 

Should it be occasioned by a bullet, extract it, and 
any pieces of cloth, &c. that may be lodged in it, if 
possible, and cover the wound with a piece of linen 
or preferably antiseptic gauze, LaKmg care that 
it is not drawn into the chest. If a portion of the 
lung protrudes, return it without any delay, but as 
gently as possible. 

OF THE BELLY. 

Close the wound by strips of sticking plaster, and 
stitches passed through the skin, about half an inch 
from its edges, and cover the whole with a soft com- 
press, secured by a bandage. Any inflammation that 
may arise is to be reduced by ice, purging, and 
u blister over the whole belly. 

Should any part of the bowels come out at the 



Wounds. 133 



wound, if clean and uninjured, return it as quickly 
as possible; if covered with dirt, clots of blood, &c. 
wash it carefully in warm water previous to so doing. 
If the gut is wounded, and only cut partly through, 
draw the two edges of it together by a stitch, and re- 
turn it; if completely divided, connect the edges by 
four stitches at equal distances, and replace it in the 
belly, always leaving the end of the ligature project- 
ing from the external wound, which must be closed 
by sticking plaster. In five or six days, if the threads 
are loose, withdraw them gently and carefully. 



Bring the edges of the wound together by sticking 
plaster, without any delay, keep the part perfectly at 
Test, bleed, purge, and live very low, to prevent in- 
flammation. Should it come on, it must be met at its 
first approach by applying an ice bladder or cloths 
dipped in cold water, over the joint, and by a blis- 
ter covering the whole joint. If a permanent stiffen 
ing of the joint seems likely to ensue, keep the liml 
in that position which will prove most useful, that is, 
the leg should be extended, and the arm bent at the 
elbow. Wounds of joinis are always highly danger- 
ous, and frequently terminate in death. 

OF TENDONS. 

Tendons or sinews are frequently wounded and 
ruptured. They are to be treated precisely like any 
other wound, by keeping their divided parts together. 
The tendon which connects the great muscle form- 
ing the calf of the leg, with the heel, called the ten- 
don of Achilles, is frequently cut with the adze, and 
ruptured in jumping from heights. This accident is 
to be remedied by drawing up the heel, extending 
the foot, and placing a splint on the fore-part of the 
leg, extending from the knee to beyond the toes 
which being secured in that position by a bandage, 
keeps the foot in lhe position just mentioned. The 



134 Compendium of Domestic Medicine. 

hollows under the splint must be filled up with tow 
or cotton If the skin falls into the space between 
the ends of the tendon, apply a piece of sticking plas- 
ter, so as to draw it out of the way. It takes five or 
six weeks to unite, but no weight should be laid on 
the limb for several months. 



OF FRACTURES. 

The signs by which fractures may be known, hav 
ing been already pointed out with sufficient minute- 
ness, it will be unnecessary to dv ell thereon ; it will 
be well, however, to recollect this general rule: in 
cases where, from the accompanying circumstances 
and symptoms, a strong suspicion exists that the bone 
is fractured, it is proper to act as though it were 
positively ascertained to be so. 

OF THE BONES OF THE NOSE. 

The bones of the nose from their exposed situation, 
are frequentlyaforced in. Any smooth article that 
will pass into the nostril should be immediately intro- 
duced with one hand, to raise the depressed portions 
to the proper level, while the other is employed in 
moulding them into the required shape. If violent 
inflammation follows, apply ice, and live on a low 
diet. 

OF THE LOWER JAW. 

This accident is easily discovered by looking into 
the mouth, and is to be remedied by keeping the 
lower jaw firmly pressed against the upper one, by 
means of a bandage passed under the chin and over 
the head. If it is broken near the angle, or that part 
nearest the ear, place a cushion or roll of linen in the 
hollow behind it, over which the bandage must pass, 
so as to make it push that part of the bone forward 



Fractures 185 

The parts are to be confined in this way for twenty 
days, during which time, all the nourishment that is 
taken, should be sucked between the teeth. If in 
consequence of the blow, a tooth is loosened, do not 
meddle with it, for if let alone it will grow fast again. 

OF THE COLLAR BONE. 

This accident is a very common occurrence, and 
is known at once by passing the finger along it, and 
Sy the swelling, <fec. To reduce it seat the patient 
in a chair without any shirt, and place a pretty stout 
compress of linen, made in the shape of a wedge, 
under his arm, the thick end of which should press 
against the arm-pit. His arm, bent to a right angle 
at the elbow, is now to be brought down to his side, 
and secured in that position by a long bandage, which 
passes over tne arm of the affected side and round 
the body. The fore-arm* is to be supported across 
the breast by a sling. It takes from four to five weeks 
to re-unite. 

OF THE ARM. 

Seat the patient on a chair, or the side of a bed, let 
one assistant hold the sound arm, while another 
grasps the wrist of the broken one and steadily ex- 
tends it in an opposite direction, bending the fore- 
arm a little, to serve as a lever. You can now place 
the bones in their proper situation. Two splints of 
shingle or stout pasteboard, long enough to reach 
from below the shoulder to near the elbow, must 
then be well covered with tow or cotton, and laid 
along each side of the arm, and kept in that position 
by a bandage. The fore-arm is to be supported in a 
sling. Two smaller splints may for better security 
be laid between the first ones, that is one on top, and 

* By the fore-arm is meant that part of it which 
reaches from the elbow to the wrist The arm ex 
lends from the shoulder to the elbow. 



136 Compendium of Domestic Medicine. 

the other underneath ihe arm, to be secured by the 
bandage in the same way as the others. 

OF THE BONES OF THE FORE-ARM. 

These are to be reduced precisely in the same 
way, excepting the mode of keeping the upper por- 
tion of it steady, which is done by grasping the arm 
above the elbow. When the splints and bandage 
are applied, support it in a sling. 

OF THE WRIST, &C. 

This accident is of rare occurrence. When it does 
happen the injury is generally so great as to require 
amputation. If you think the hand can be saved, 
lay it on a splint well covered with tow; this extends 
beyond the fingers; place another splint opposite to 
it, lined with the same soft material, and secure them 
by a bandage. The hand is to be carried in a sling. 

The bones of the hand are sometimes broken. 
When this is the case, fill the palm with soft com- 
presses or tow, and then lay a splint on it long enough 
to extend from the elbow to beyond the ends of the 
fingers, to be secured by a bandage, as usual. 

When a finger is broken, extend the end of it until 
it becomes straight, place the fractured portion in its 
place, and then apply two small pasteboard splints, 
Due below and the other above, to be secured by a 
narrow bandage. The top splint should extend from 
the end of the finger over the back of the hand. It 
may sometimes be proper to have two additional 
splints for the sides of the finger. 

OF THE RIBS. 

When after a fall or blow, the patient complains 
of a pricking pain in his side, we may suspect a rib 
is broken. It is ascertained by placing the tips of 
two or three fingers on the spot where the pain is, 
and desiring the patient to cough, when the grating 
sensation will :>e felt. All that is necessary, is to 



Fractures. 137 

pans a broad bandage round the chest, so tig ht as to 
prevent the motion of the ribs in breathing and to 
observe a low diet 

OF THE THIGH. 

A fracture of this bone is known by the deformity 
of the thigh, the shortness of the whole limb when 
compared with its fellow, and by a great swelling at 
the fractured part. All that can be done in the event 
of this serious accident, is to send for the nearest 
physician. The apparatus to reduce it is so complex 
that none but a surgeon can apply it. 

OF THE KNEE-CAP. 

This accident is easily ascertained on inspection. 
[t may be broken in any direction, but is most gene- 
rally so across or transversely. It is reduced by 
bringing the fragments together and keeping them 
in that position by a long bandage passed carefully 
round the leg, from the ankle to the knee, then press- 
ing the upper fragment down so as to meet its fellow, 
(the leg being extended) and placing a thick compress 
of linen above it, over which fhe bandage is to be 
continued. 

The extended limb is now to be laid on a broad 
splint, extending from the buttock to the heel, thickly 
covered with tow to nil up the inequalities of the leg. 
For additional security, two strips of muslin may be 
nailed to the middle of the splint, one on each side, 
and passed about the joint, the one below, the other 
above, so as to form a figure of eight. ' In twenty or 
thirty days, the limb should be moved a little to pre- 
vent stiffness. 

If the fracture is ihrough its length, bring the paru 
together, place a compress on each side, and keep 
them together with a bandage, leaving the limb ex- 
tended and at rest. Any inflammation in this, or 
other fracture, is to be combated by cold applica 
tions, &q. &e. 



138 Compendium of Domestic Medicine. 



OF THE LEG. 

From the thinness of the parts covering the princi- 
pal bone of the leg, it is easy to ascertain if it is bro- 
ken obliquely. If) however, the fracture be directly 
across, no displacement will occur, but the pain, 
swelling, and the grating sensation, will sufficiently 
decide the nature of the accident. 

If the fracture is oblique, let two assistants extend 
the limb, while the broken parts are placed by the 
hand in their natural position. Two splints that 
reach from a little above the knee, to nine or ten 
nches below the foot, having near the upper end of 
each, four holes, and a vertical mortice near the 
lower end into which is fitted a cross piece, are now 
50 be applied as follows. Lay two pieces of tape, 
ibout a foot lung, on each side of the leg, just below 
he knee joint, and secure them there by several turns 
)f a bandage ; pass a silk handkerchief round the 
inkle, cross ic on the instep, and tie it under the sole 
A' the foot. The two splints are now placed one on 
each side of the lejg, the four ends of the pieces of 
tape passed through the four holes and firmly tied, 
and the crosa piece placed in the mortice. By tying 
(he ends of the handkerchief to this cross piece the 
business is finished. 

If the fracture is across, and no displacement exists, 
app t y two splints of stout pasteboard, reaching from 
the heel to the knee, and well covered with tow, one 
on each side of the leg, securing them by a bandage 
passing round the limb, and outside the splints. 

OF THE BONES OF THE FOOT. 

The bone of the heel is sometimes, though rarely, 
broken. It is known by a crack at the moment of the 
accident, a difficulty in standing, by the swelling, and 
by the grating noise on moving the heel. To reduce 
it, take a long bandage, lay the end of it on the top 




THE DORSAL SURFACE OF THE LEFT FOOT. 

1, the astragalus, its upper articular surface. 2, its an- 
terior extremity, which articulates with (4) the sca- 
phoid bone. 3, the oscalcis, or heel-bone. 4. the sca- 
phoid bone. 5, the internal cuneiform bone. 6, the 
middle cuneiform bone. 7, the external cuneiform 
bone. 8, the cuboid bone. 9, the metatarsal bones of 
the first and second toes. 10, 11, the first and second 
phalanges of the great toe. 12, 13, 14, the first, second, 
and third phalanges of the second toe. 



Fractures. 139 



of the foot, carry it over the toes under the sole, and 
then by several turns secure it in that position. 

The foot being extended as much as possible, carry 
the bandage along the back of the leg above the 
knee, where it is to be secured by several turns, and 
then brought down on the front of the leg, to which 
it is secured by circular turns. In this way the bro- 
ken pieces will be kept in contact, and in the course 
of a month or six weeks will be united. 

Fractures of the foot, toes, &c. are to be treated like 
those of the hand and fingers. 



OF DISLOCATIONS. 

The signs by which a dislocation may be known, 
have been already mentioned. It is well to recollect 
that the sooner the attempt is made to reduce it, the 
easier it will be done. The strength of one man, 
properly applied at the moment of the accident, will 
often succeed in restoring the head of a bone to its 
place, which in a few days would have required the 
combined efforts of men and pulleys. If after several 
trials with the best apparatus that can be mustered, 
you find you cannot succeed, make the patient drink 
strong hot toddy, of brandy or other spirits, until he 
is very drunk. In this way, owing to the relaxed 
state of the muscles, a very slight force will often be 
sufficient, where a very great one has been previ- 
ously used without effect. 

If any objections are made to this proceeding, or 
if the patient will not consent to it, having your ap- 
paratus (which is presently to be mentioned) all 
ready, let him inhale chloroform or ether until com 
pletely under its influence ; the iustant this happen? 
apply your extending and counter-extending forces 
Another important n le is, to vary the direction of 
the extending force A slight pull in one way, will 



140 Compendium of Domestic Medicine. 

often effect what has been in vain attempted by great 
force in another. 

OF THE LOWER JAW. 

This accident, which is occasioned by blows, or 
/awning, is known by an inability to shut the mouth, 
and the projection of the chin. To reduce it, seat 
the patient in a chair with his head supported bv the 
breast of an assistant, who stands behind him. Your 
thumbs being covered with leather, are then to be 
pushed between the jaws, as far back as possible,, 
while with the fingers, outside, you grasp the bone, 
which is to be pressed downwards at the same time 
that the chin is raised. If this is properly done, the 
bone will be found moving, when the chin is to be 
pushed backwards, and the thumbs slipped between 
the jaws and the cheeks. If this is not done, they 
will be bitten by the sudden snap of the teeth as they 
come together. The jaws should be kept closed by 
a bandage for a few days, and the patient live upon 
soup. 

OF THE COLLAR BONE 

This bone is rarely dislocated. Should it occur 
apply the bandages, &c. directed for a fracture of 
the same part. 

OF THE SHOULDER. 

Dislocation of the shoulder is the most common 
of all accidents of the kind. It is very easily known 
by the deformity of the joint, and the head of the 
bone being found in some unnatural position. To 
reduce it, seat the patient in a chair, place one hand 
on the prominent part of the shoulder blade, just 
above the spot where tne head of the bone should 
be, while with the other you grasp the arm above 
the elbow and puli it outwards. 

Should this not succeed, lay the patient on the 
ground, piace your heel in his arm-pit, and steadily 



Dislocations. 141 



and forcibly extend the arm, by grasping it at the 
wrist. The same thing may be tried in various posi- 
tions, as placing yourself on the ground with him ; 
laying him on a low bed, while you are standing 
near the foot of it, &c. 

If this fails, pass a strong band over the shoulder, 
carry it across the breast, give the ends to assistants, 
or fasten them to a staple in the wall ; the middle of 
a strong band or folded towel is now to be laid on the 
arm above the elbow, and secured there by numerous 
turns of a bandage. The two ends of the towel be- 
ing then given to assistants, or connected with a 
pulley, a steady, continued and forcible extension is 
to be made, while with your hands you endeavour 
to push the head of the bone into its place. 

OF THE ELBOW. 

If the patient has fallen on his hands, or holds ni& 
arm bent at the elbow, and every endeavour to 
straighten it gives \im pain, it is dislocated back- 
wards. Seat him in a chair, let one person grasp the 
arm near the shoulder, and another the wrist, and 
forcibly extend it, while you interlock the fingers of 
both hands just above the elbow, and pull it back- 
wards, remembering that under those circumstances, 
whatever degree of force is required, should be ap- 
plied in this direction. 

The elbow is sometimes dislocated sideways or 
laterally. To reduce it, make extension by pulling 
at the wrist, while some one secures the arm above, 
then push the bone into its place, either inwards or 
outwards, as may be required. After the reduction 
of a dislocated elbow, keep the joint at perfect rest 
for five or six days, and then move it gently. If in- 
flammation comes on, apply ice bladder, &c. Ac. 

OF THE WRIST, FINGERS, &C. 

Dislocations of the wrist, fingers and thumb, are 
readily perceived on examination; they are all to be 



142 Compendium of Domestic Medicine. 

reduced by forcibly extending the lower extremity 
of the part, and pushing the bones into their place. 
If necessary, small bands may be secured to the fin- 
gers by a narrow bandage, to facilitate the extension. 
These accidents should be attended to without delay 
for if neglected for a little time, they become ir 
remediable. 

OF THE THIGH. 

Notwithstanding the hip joint is the strongest one 
in the body, it is sometimes dislocated. When this 
accident occurs, which may be readily ascertained 
by comparing the limb with its fellow, &c. send foi 
a surgeon as soon as possible. 

OF THE KNEE-CAP. 

When this little bone is dislocated, it is evident en 
the slightest glance. To reduce it, lay the patient 
on his back, straighten the leg, lift it up to a right 
angle with his body, and in that position push the 
bone back to its place. The knee should be kept at 
rest for a few days. 

OF THE LEG 

Procure a surgeon as quickly as possible. 

OF THE FOOT. 

The foot is seldom dislocated. Should it happen, 
however, let one person secure- the leg, and another 
draw the foot, while you push the bone in the con- 
trary way to that in which it was forced out The 
part is then to be covered with compresses dipped 
in lead water, and a splint appi ed on each side of 
the leg that reaches below the foot Aer«dents of 
this nature are always dangerous, an mat can be 
done to remedy them consists in the speedy reduc- 
tion of the bone, keeping the parts at rest, and 
subduing inflammation by cold, low diet, <fec. <fce. 



Compound Accidents. 14S 



OF COMPOUND ACCIDENTS. 

Having spoken of the treatment to be pursued for 
a bruise, wound, fracture and dislocation, as happen- 
ing singly, it remains to state what is to be done when 
they are united. 

We will suppose that a man has been violently 
thrown from a carriage. On examination, a wound 
is found in his thigh bleeding profusely, his ankle is 
out of joint w T ith a wound communicating with its 
cavity, and the leg broken. 

In the first place stop the bleeding from the wound 
in the thigh; reduce the dislocation next ; draw me 
edges of the wounds together with sticking plaster: 
*nd procure a surgeon as quickly as possible. 

If, instead of a wound, fracture and dislocation, 
thero is a concussion or compression of the bram, a 
lislocati^n and fracture, attend to the concussion 
first, the dislocation next, and the fracture the last 



OF AMPUTATION. 

This operation should never be attempted except 
by a surgeon. 

If a limb be nearly severed from the body by ac- 
cident, and hang merely by a slip of skin or muscle, 
it may be divided with a sharp knife. 



OF SUSPENDED ANIMATION 

FROM DROWNING. 

The common methods of rolling the body oi a 
drowned person on a barrel, or holding it up "by the 



144 Compendium of Domestic Medicine. 

heels, &c. are full of danger, and should never be 
permitted. If a spark of life should happen to re- 
main, this violence would extinguish it for ever.* As 
soon, therefore, as the body is found, convey it as 
gently as possible to the nearest house, strip it of the 
wet clothes, dry it well, and place it on a bed be- 
tween warm blankets, on the right side, with the 
head elevated by pillows. Every part is now to be 
well rubbed with flannels dipped in warm brandy, or 
spirits of any kind, while a warming pan, hot bricks, 
or bottles or bladders filled with warm water, are 
applied to the stomach, back, and soles of the feet. 
During these operations a certain number of the as- 
sistants (no more persons are to be allowed in the 
room than are absolutely necessary) should try to 
inflate the lungs, by blowing through the nozzle of a 
common bellows, or a pipe of any kind, placed in 
one nostril, while the other with the mouth is kept 
closed. An assistant standing at the head of the 
body should take hold of the arms at the wrists, 
and raise the arms up to the head, and then throw 
them forward on the chest, thus dilating and con- 
tracting the thorax, making artificial respiration. 

All these operations, particularly rubbing the body 
and trying to inflate the lungs, should be continued 
for six or eight hours, and when the patient has come 
to himself, small quantities of warm wine, wine- 
whey, brandy and water, &c. may be given to him, 
from time to time 

Should the accident occur in winter, and the body 
feel cold, as if frozen; previously to applying warmth, 
rub it well with snow, ice, or very cold water 
Above all things remember that perseverance for 
many hours in the remedies pointed out, may give 



* The seal of the Humane Society beautifully* ex 
presses this fact. It represents a little boy blowing 
a coal, the motto 'If I mistake not> " a spark may re 



Suspended Animation. 145 



you the unspeakable pleasure of restoring & fellow 
Creature to life. 



FROM COLD. 

Take the body into a room, the doors and windows 
of which are open, and where there is no fire, and 
c ub it with snow,* or cold water. After a while, fric- 
tions with flannels and hot spirits are to be used, as in 
the preceding case, and warmth very gradually ap 
plied. The lungs are 10 be inflated as directed in 
cases of drowning, and when the pau>nt i& able to 
swallow, warm wine, &c. may be given in small 
quantities. 

If a limb is frost-bitten, the cold applications shoulc 
be continued longer, and warmth be more gradually 
applied than when the whole body is frozen. Care 
should be taken to handle the parts carefully, so as 
not to break off the ear, tip of the nose, <fec. 

FROM HANGING. 

The remedies for this accident are the same as in 
drowning, with the addition of taking away a small 
quantity of blood, by cupping glasses, from the neck, 
or by opening the jugular vein. 

FROM FOUL AIR. 

Throw open the doors and window's, or take tne» 
patient into the open air, and seat him, undressed, 
well wrapped in a blanket, in a chair, leaning a little 
to the right side, place his feet or whole body in a 
bath, and sprinkle his stomach w 7 ith cold vinegar oi 
w 7 ater, and rub it immediately with flannels dipped 
in oil. Clysters of vinegar and water are to be in- 

* If this can be procured in plenty, the patient, 
with the exception of his face, which should be left 
out, may be completely covered with it to the thick- 
ness of two feet. 
K 



146 Compendium of Domestic Medicine. 

jected, and when animation returns, continue the 
frictions, and give warm mint tea, &c. 



OF SWALLOWING POISONS. 

The first thing to be done when a person is dis- 
covered 10 have swallowed poison is, to ascertain 
what it is he has taken: the next, to be speedy in 
resorting to its appropriate remedies. If any one of 
these cannot be had, try some other without loss of 
time. 



Oil of Vitriol, — Aqua Fortis, — Spirits of Sea Salt, 
— Oxalic Acid. 

Symptoms. A burning heat in the mouth, throat 
and stomach, — stinking breath, — an inclination to 
vomit, or vomiting of various matters mixed with 
blood, — hiccups, — costiveness or stools more or less 
bloody, — pain in the belly, so great that the weight 
of a sheet cannot be borne, — burning thirst, — diffi- 
culty of breathing, — suppression of urine, &c. 

Remedies. — Mix an ounce of calcined magnesia 
with a pint of water, and give a glassful eveiy two 
minutes. If it is not. at hand, use flaxseed tea, rice 
water, or water alone in large quantities, until the 
former can be procured. If it cannot be obtained, 
dissolve an ounce of soap in a pint of water, and take 
a glassfu. every two minutes; chalk or whiting may 
also be taken by the mouth, and clysters of milk be 
frequently injected. If the patient will not vomit, 
put him m the warm bath, bleed him freely, and 
apply leeches and blisters over the parts pained. If 
the cramps and convulsions continue, give him a cup 
cf common tea, with an ounce of sugar, forty drops 
of Hoffman's anodyne and fifteen or twenty of lauda- 
num e^ ?ry quarter of an hour. No nourishment but 



Sicallowmg Poisons. 147 

weetened rice water is to be taken for several days. 
In these cases never give tartar emetic, ipecacuanha, 
or tickle the throat with a feather; they only increase 
the evil. 

ALKALIES. 

Caustic Potash, — Caustic Soda, — Volatile Alkali. 

Symptoms. These substances occasion the same 
effects as acids, producing dreadful convulsions. 

Remedies. Take two table spoonsful of vinegar 
or lime juice in a glass of water at once, follow it up 
by drinking large quantities of sugar and water. 
Pursue the same treatment as in poisons from acids. 

MERJ'JRY. 

Corrosive Sublimate, — Red Precipitate, — Vermilion. 

Symptoms. Constriction and great pain in the 
throat, stomach and bowels, — vomiting of various 
matters mixed with blood, — unquenchable thirst, — 
difficulty of urine, — convulsions. 

Remedies. Mix the white- of a dozen or fifteen 
eggs with two pints of cold water, and give a glassful 
every two minutes, with as much milk as can be 
swallowed, and large doses of ipecacuanha. If aftei 
the egg mixture is all taken, the vomiting does not 
stop, repeat the dose, with the addition of more 
water. Leeches, the warm bath, blisters, &c. are to 
be used to reduce the pain and inflammation, as be 
fore directed. 



Symptoms. These are the same as produced by 
the mercurial poisons. 

Rejiedies. Give large quantities of cold sugar and 
water, until a plentiful vomiting is induced, to assist 
which, ipecacuanha* may be taken in considerable 

* To render it more active, ten grain? of sulphate 
of zinc may be added to it. 



148 Compendium of Domestic Medici?ie. 

doses at the same time ;* barley, rice water, flaxseeu 
tea, milk, &c. should afterwards be employed. Oil 
is never to be used in this case until the symptoms 
have considerably abated, or the poison has been 
ejected. 

corPEit. 
The symptoms occasioned by swallowing verdigris, 
are nearly the same as those of' the mercurial poisons. 
The great remedy is large quantities of sweetened 
water. In addition to this, use all the means recom- 
mended for corrosive sublimate, &c. 

ANTIMONY. 

Antimonial Wine, — Tartar Emetic, — Butter of An- 
timony, tyc. 

Symptoms. Excessive vomiting, — pain and cramp 
in the stomach, — convulsions, &c. 

Remedies. Encourage the vomiting by sugar and 
water, and if after a while it does not stop, give a 
grain of opium in a glass of the sweetened water, 
every fifteen minutes. To relieve the pain, apply 
leeches to the stomach, throat or parts affected. 

SALTS OF TIN. 

Give as much milk as can be got down, and if it is 
not at hand, use large quantities of cold water to in- 
duce vomiting. If the symptoms do not abate, pursue 
the plan directed for acids. 

SALTS OF BISMUTH, GOLD AND ZINC. 

Pursue the plan recommended for arsenic. 

LUNAR CAUSTIC 

Dissolve two table spoonsful of common table saU, 
in two pints of water; a few glasses of this will in- 

* Equal parts of lime w T ater and sugared water may 
also be used. 



Swallowing Poisons. 149 

duce vomiting If not relieved, drink flaxseed tea. 
apply leeches, &c. as for acids. 

SALT-PETRE. 

Pursue the plan recommended for arsenic omitting 
the lime water. 



SAL AMMONIAC. 

Symptoms. Vomiting, — pain in the belly, — a stiff- 
ness of the whole body, — convulsions. 

Remedies. Introduce your finger or a feather into 
the throat to induce vomiting, and give plenty of 
sweetened water. To relieve the convulsions give 
the tea, laudanum, &c. as for acids, or the laudanum 
alone, and to ease the pain in the belly, apply 
leeches, &c. 

LIVER OF SULPHUR. 

Symptoms. They resemble those caused by salt- 
petre. 

Remedies. Two table spoonsful of vinegar in a 
glass of water, are to be frequently taken until vomit- 
ing is brought on, after whi(*h, havfi recourse lc 
leeches, blisters, &c. 

PHOSPHORUS. 

The symptoms and remedies are the same as by 
poison from acids. 

SPANISH FLIES. 

Symptoms. Great pain in the stomach, with obsti- 
nate and painful erections, accompanied by a diffi- 
culty or suppression of urine, or if any is passed, it 
is bloody, — a horror of swallowing liquids, — frightful 
convulsions. 

Remedies. Make the patient swallow as much 
sweet oil as he can possibly get down. Milk ana 
sugared water are also to be freely used. In addition 



150 Compendium of Domestic Medicine. 

to the plan recommended for acids, solutions of gum 
arable, or flaxseed tea, are to be injected into the 
bladder. If no vomiting is induced, put him in the 
warm bath, continue the sweetened water, and rub 
his thighs and legs with two ounces of warm oil, in 
which a quarter of an ounce of camphor has been 
dissolved. Eight or ten grains of camphor may be 
mixed with the yolk of an egg and taken internally. 
If there is acute pain in the bladder, apply leeches 
over it. 

POWDERED GLASS. 

Stuff the patient with thick rice pudding, bread, 
potatoes or any other vegetable, then give him live 
grains of tartar emetic to vomit him, after which, use 
milk freely, clysters and fomentations to the belly 
with the warm bath ; leeches, &c. are not to be neg- 
lected. 



Sugar of Lead, — Extract of Saturn, — White L-ead 
— Litharge, — Minium. 

" Symptoms. A sweet astringent taste in the mouth, 
—constriction of the throat, — pain in the stomach, — 
bloody vomiting, &c. 

Remedies. Dissolve a handful of Epsom or Glau- 
ber salts in a pint of water and give it at once ; when 
it has vomited him, use sweetened water. If the 
symptoms continue, act as directed for acids. 

OPIUM, OR LAUDANUM. 

Symptoms. Stupor, — an insurmountable inclina- 
tion to sleep, — delirium, — convulsions, &c. 

Remedies. Endeavour to excite vomiting by six 
grains of tartar emetic, or four grains of blue., or thirty 
of white vitriol. Thrust a feather down the throat 
for the same purpose. Never give vinegar or other 
acids, until the poison is altogether or nearly evacu- 
ated. After this has taken place, a wine glassful of 



Swa'Jiwing Poisons, 15! 

lemon juice and water may be taken every five 
minutes, along with a cup of very strong coffee. The 
coffee, &c. are to be continued until the drowsiness 
is gone off) which, if it continues, and resembles that 
of apoplexy, must be relieved by bleeding. The 
patient is to be forcibly kept in constant motion. 

MUSHROOMS, 

Remedies. Give the patient immediately, three 
grains of tartar emetic, twenty-five or thirty of ipe- 
cacuanha, and an ounce of salts, dissolved in a glass 
of water, one third to be taken every fifteen minutes 
until he vomits freely. Then purge with castor oil. 
If there is great pain in the belly, appPy leeches, blis- 
ters, &c. 

TOBACCO, HEMLOCK, NIGHT-SHADE, SPURRED RYE. 

Remedies. An emetic as directed for opium. If 
the poison has been swallowed some time, purge with 
castor oil. After vomiting and purging, if the patient 
seems drowsy, bleed him, and give vinegar and water. 

POISONOUS FISH. 

Remedies. An emetic. If it has been eaten some 
time, give castor oil by the mouth and clyster. After 
these have operated, twenty drops of ether may be 
taken on a lump of sugar; vinegar and water as be- 
fore mentioned. 



FOREIGN BODIES IN THE THROAT. 

Persons are frequently in danger of suffocation 
from fish bones, pins, &c. which stick in the throat 
The moment an accident of this kind occurs, desire 
the patient to be perfectly still, open his mouth and 
look into it. If you can see the obstruction, endea- 
vour to seize it with your finger and thumb, or a long 



152 Compendium of Domestic Medicine. 

slender pair of pincers. If it cannot be got up, or is 
not of a nature to do any injury in the. stomach, push 
it down with the handle of a spoon or a flexible round 
piece of whale-bone, the end of which is neatly 
1 wered with a roll of linen, or any thing that may be 
ai hand.* If you can neither get it up nor down, 
place six grains of tartar emetic in the patient's mouth. 
As it dissolves, it will make him excessively sick, and 
in consequence of the relaxation, the bone, or what- 
ever it may be, will descend into the stomach or be 
ejected from the mouth. 

If a pin, button, or other metallic or pointed body 
has been swallowed (or pushed into the stomach) 
make the patient eat plentifully of thick rice pudding, 
and endeavour to prevent him from going to stool for 
at leasL twelve hours. 



OF BURNS AND SCALDS. 

There are three kinds of remedies employed in ac- 
cidents of this nature. Cooling applications, such as 
pounded ice, — snow, — vinegar, — cold water, — lead- 
water, &c. Stimulants, as w r arm spirits of turpen- 
tine, — brandy, or any ardent spirits, and carded or 
raw cotton. 

Any one of these articles that happens to be nearest 
at hand, may be tried, although the preference is due 
to the turpentine or spirits, which being made as hot 
as the patient can bear it, is to be applied to all the 
burned surface (so as not to touch the adjoining sound 
skin) until some common basilicon ointment can be 
thinned with spirits of turpentine, to the consistence 
of cream in which state it is to be spread on a linen 
rag and laid over the part, taking care, as before, not 
lo let it touch the sound skin. 

* The small end of a common riding whip answers 
very well. 



Bums and Scalds. 150 

If, however, (the rule is general) this plan causes 
great pain and inflammation, it must be abandoned, 
and one of the others be resorted to, as the pounded 
ice, which can be readily applied in a bladder. 
Eq ual parts of lime water and linseed oil well mixed, 
forms one of the most soothing of all applications. 
Should much fever prevail, it is to be reduced by 
bleeding, purging, &c. but if on the contrary, the sys- 
*em seems to sink, wine, bark, &c. must be employed 



OF MORTIFICATION. 

From what has already been stated, it is evident 
that in treating wounds, &c. as well as diseases, one 
great and important indication is to repress excessive 
inflammation, which, if allowed to proceed to a cer- 
tain point, sometimes produces mortification or the 
death of the parts. 

Whenever, therefore, from the violence of the 
fever, heat, pain, redness and swelling, you are fear- 
ful of its ending in this way, apply ice bags or 
cloths dipped in cold water over the part. If, how- 
ever, the fever and pain suddenly cease, if the part 
which before was red, swollen and hard, becomes 
purple and soft, abandon at once all reducing mea- 
sures, apply warmth over the whole of the parts, 
and give wine, porter, bark, &c, freely and with- 
out delay. If the warmth does not put a stop to the 
disease, and the parts become dead and offensive, 
cover them with a charcoal or fermenting poultice 
until nature separates the dead parts from the 
living, during which process a generous diet, bark, 
&c, must be allowed. 

There is a particular kind of mortification which 
comes of itself, or without any apparent cause. It 
attacks the small toes of old people, and commences 
in a small bluish or black spot, which spreads to dif- 
ferent parts of the foot. To remedy it, place a blister 
rnrer the eoot, and give two gi \ins of opium night and 



154 Compendium of Domestic Medicine. 

morning ; taking care to keep the bowels open by 
castor oil, and to diminish the quantity of the opium 
if it occasions any unpleasant effects. 

In extensive mortifications of the fore-arm, it is 
necessary to amputate. This, however, should never 
be done, until by the repeated application of blisters 
to the sound parts adjoining the mortified ones, they 
are disposed to separate, which may be easily known 
by inspection. 



DIRECTIONS FOR BLEEDING. 

Tie up the arm, placing the bandage at least two 
inches above the projections of the elbow joint, and 
then feel for the pulse at the wrist. If it is stopped, 
the bandage is too tight, and must be relaxed. Select 
the most prominent vein, and feel with the tip of 
your finger if an artery lies near it. If you feel one 
pulsating so close to the vein that you are fearful of 
wounding it, choose another. Having set your lan- 
cet (of course a spring lancet), bend the arm to the 
precise position it is to keep while the blood flows. 
Now place the cutting edge of the lancet on the vein, 
while you depress the handle or frame just as much 
as you wish the cut to be deep ; by touching the spring 
on the side with your thumb the business is dene. 
To stop the bleeding, relax the bandage, press the 
two edges of the wound together, place a little com- 
press of linen on it, and bind up the w T hole with a 
bandage passing round the joint in a figure of eight. 



DIRECTIONS FOR PASSING CATHETERS. 

Take the penis of the patient near its head be- 
tween the finger and thumb of your left hand (stand- 
ing beside him), while with your right you introduce 




VEINS OF THE ARM. 



Directions for Passing Catheters. 15& 

the point of the instrument into the urinary passage, 
its convex side towards his knees ; while you push 
the catheter down the urethra, endeavour at the 
same time to draw up the penis on it. When you 
first introduce it, the handle will of course be near 
the belly of the patient, and as it descends will be 
*hrown farther from it, until it enters the bladder 
which will be known by the flow of the unne. If 
you cannot succeed while the patient is on his back, 
make him stand up, or place hin: with his shoulders 
and back on the ground, while his thighs and legs 
are held up by assistants. If still foiled, place him 
again on his back, and when you have got the cathe- 
ter as far down as it will go, introduce the forefinger, 
,vell oiled, into the fundament, and endeavour to 
push its point upwards, while you still press it for- 
ward with the other hand. Force is never, on any 
account, to be used. Vary your position as often as 
you please, let the patient try it himself, but always 
remember it is by humouring the instrument, and not 
by violence, that you can succeed. 



DIRECTIONS FOR PASSING BOUGIES. 

Take the penis betw r een your finger and thumb, 
and pass the point of the instrument (which should 
be well oiled) down the urethra as directed for the 
catheter; when it has entered three or four inches, 
depress the penis a little, and by humouring the bou- 
gie with one hand and the penis with the other, en- 
Jeavour to pass it as far as may be wished. The 
patient himself will frequently succeed when every 
me els? fails. 

The passing of catheters and bougies should 
never be undertaken excepting by someone 
skilled in the handling of them. 

The flexible soft rubber catheters are used 
almost exclusively now. 



156 Compendium of Domestic Medicine. 
CHAPTER IV. 

Prescriptions referred to in the preceding pages. 



No. 1. Saline Mixture. R.* Salts of Tartar, 1 
drachm, — Water, 4 ounces, — Essence of Peppermint, 
3 drops. When the salt is dissolved, add very gradu- 
ally lemon juice or vinegar, 1 ounce, or till the 
tflervescence ceases. To be taKen every hour. 

No. 2. R. Sulphate of Quinine, 13 grains, — Gum 
iv^abic powdered, 1 drachm, — Loaf Sugar, J an 
ounce, — Water, 6 ounces, — Essence of Peppermint, 
5 drops. A table spoonful every hour, shaking the 
bottle well before it is poured out. 

No. 3. R. Calomel, 6 grains, — Antimonial Pow 
ders, 3 grains. To be taken every three hours. 

No. 4. Effervescing Mixture. R. Salt of Tartar, 
20 grains, — Water, 2 ounces, — Essence of Pepper- 
mint, 2 drops. When the salt is dissolved, add a 
table spoonful of lemon juice, or good vinegar, and 
swallow it immediately. 

No. 5. K £halk Mixture, 4 ounces, — Tincture of 
Kino, 1 drachm, — Lavender Compound, 1 drachm, — 
Laudanum, 30 drops. A table spoonful every two 
or three hours, as may be required. 

No. 6. R. Cayenne Pepper, 6 ounces, — Common 
Salt, 4 drachms, — Boiling Water, 1J pints,— Boiling 
Vinegar, 1J pints. Let it remain in a close vessel 
for an hour, then strain it through a fine linen cloth. 

* R. stands for Recipe or " Take." The weights 
used in these Prescriptions are troy or apothecary's 
—not avoirdupois weight. 



Prescriptions, 157 

Take a table spoonful every hour or two, according 
Iq circumstances. 

No. 7. R. Musk, 1 drachm, — Gum Arabic jiow- 
dered, 1 drachm, — Loaf Sugar, 1 drachm, — Water, 6 
ounces. Rub up tne musk with tb^ sugar, then add 
the gum and pour on the water very gradually, so as 
to incorporate the whole. Take a table spoonful 
every two hours. 

No. 8. R. Camphor, 30 grains, — Almonds blanch- 
ed, 2 drachms, — Loaf Sugar, 1J drachms, — Pepper- 
mint Water, 6 ounces. Moisten the camphor with a 
few drops of spirits of wine, and reduce it to powder. 
The almonds and sugar having been beat to a paste, 
add the camphor, and pour on the water gradually, 
rubbing the whole well together. Take a table 
spoonful every two or three hours. 

No 9. R. Sugar of Lead, 5 grains, — White Vit- 
riol, 2 grains, — Laudanum, 2 drachms, — Rose Water, 
6 ounces. -Or, Wine of Opium, \ an ounce, — Wa- 
ter, 2 ounces. — —Or, Alum, \ a drachm, — Rose Wa- 
ter, 6 ounces. To bathe the eye frequently. 

No. 10. R. Barley Water, J a pint, — Vinegar, 1 \ 

ounces. Or, Alum, 1 drachm, — Rice Water, l| 

pints, — Honey, 1 ounce. Or, Vinegar, 2 ounces, 

— Water, 1 pint. To gargle the throat. 

No. 11. R. Barley or "Rice Water, J a pint,— 
Tincture of Myrrh, \ an ounce, — Muriatic Acid, J a 

drachm. Or, Sharp Vinegar, 1 ounce. Gargle the 

throat frequently. 

No. 12. Wine or Vinegar whey. R. Place a sauce 
pan containing a pint of new milk, on the fire, and 
while it is boiling add one gill of white wine or 
half the quantity of good vinegar. As soon as the 
milk is turned, take it off) strain the whey through a 
cloth and sweeten it to your taste. 

No. 13. R. Paregoric, \ an ounce, — Syrup ol 
Squills, 1 ounce, — Antimonial Wine, 2 drachms,— 
Water, 6 ounces. Take two tea spoonsful every fif 
teen minutes, until the cough is relieved. 

No. 14. R. The White of 1 Egg,— Castor Oil, S 



158 Compendium of Domestic Medicine. 

ounces, — Lavender Compound, 2 drachms, — Sugar, k 
an ounce, — Water, 4 ounces. Incorporate the oil and 
the white of the egg, by shaking in a bottle, then add 
the water containing the sugar and lavender. Half 
may be taken at once, and the other half in a few 
hours, or a table spoonful hourly until it operates. 

No. 15. R. Chalk Mixture, 4 ounces, — Tincture 
of Kino, 1 drachm, — Cinnamon Water, 2 ounces, — 
Laudanum, J a drachm. A table spoonful every two 
hours, or oftener if necessary. 

No. 16. R. Tincture of Catechu, 2 ounces. Take 
two tea spoonsful in a little port wine, every hour, or 
oftener if required. 

No. 17. R. Extract of Logwood, 20 grains, — Cin 
namon Water, 2 ounces, — Tincture of Kino, 1 drachm, 
— Sugar, 2 drachms. To be taken at once. 

No. 18. R. Prepared Chalk, 2 drachms,— Loaf 
Sugar, 1 drachm. Rub them well together, and add 
gradually of mucilage of Gum Arabic, 1 ounce, — 
Water, 6 ounces, — Lavender Compound, 2 drachms, 
— Laudanum, 30 drops. A table spoonful every hour 
or oftener if necessary. 

No. 19. R. Calomel, 10 grains, — Jalap, 12 grains, 
— Opium, 1J grains, — Tartar Emetic, J a grain, — Oil 
of Aniseed, 1 drop. Make the whole into a mass 
with conserve of roses, and divide it into five or six 
pills, all of which are to be taken at once. 

No. 20. R. Socotrine Aloes, 1 ounce, — Liquorice, 
2 ounces, — Coriander Seeds, J an ounce. Digest the 
aloes and liquorice in 1 pint of brandy for a week, 
shaking the bottle frequently, and add half a pint of a 
very strong decoction of Carolina Pink Root. Dose, 
two table spoonsful every morning, fasting. 

No. 21. R. Powder of the root of the Male Fern, 
1 drachm. This is to be taken in molasses early in 
the morning, and for two days in succession, to be 
followed with some very active purgative. 

No. 22. R. Powder of Tin, 1 drachm, — Molasses 
as much as will envelope it. Repeat the dose morning 
and evening for three days, and then take some acti ve 



Prescriptions 159 



purgative. Or, Bark of the fresh root of Pride of 

China, 5 ounces , — Water, 2 pints. Boil it in a close 
vessel to ono pin™ Dose, a table spoonful every two 
hours till it operates. Or, Bark of the 'Cabbage- 
tree, 1 ounce, — Water, 2 pints. Boil to one pint and 
strain. Dose, a wine glassful or about tw r o ounces. 

No. 23. R. Mucilage of Gum Arabic, 1 jounces,— 
Olive Oil, 2 drachms. Mix them well, and add Ether 
1 drachm, — Laudanum, 20 drops. Take at once. 

No. 24. R. Peruvian Bark, 20 grains, — Uva Ursi 
20 grains. — Opium, J a grain. Make a powder, to be 
taken three times a day with lime water. 

No. 25. R. Compound Tincture of Senna, 1 ounce 
— Compound Tincture of Jalap, 2 drachms. 

No. 26. R. Calomel, 10 grains, — Jalap, 15 grains, 
— Oil of Aniseed, 2 drops. To be taken in molasses. 

No. 27. R. Compound Tincture of Senna, 1 ounce, 
— Wine of Aloes, 2 ounces, — Simple Syrup, 1 ounce, 
— Water, 4 ounces, — Oil of Mint, 2 drops. A tabh 
spoonful from time to time, as may be necessary. 

No. 28. R. Muriate of Ammonia, J an ounce, — 
Vinegar, 2 ounces, — Proof Spirits, 3 ounces,— Water, 
3 ounces. Mix them for a wash. 

No. 29. Scudamore's Lotion for Govt. R. Alcohol, 
3 ounces, — Camphor Mixture, 9 ounces. Render the 
whole milk vxirm, by adding boiling water. 

No. 30. R. Water of Ammonia, 2 drachms, — Oli ve 
Oil, 1 h ounces, — Laudanum, ^ an ounce. Shake well. 

No." 31. R. Opium in fine powder, 2^ drachms, — 
Soap Liniment, 2 ounces, — Spirits of Camphor, 2 
ounces. Pour the liniment gradually on the opium 
rub well together, and add the spirits of camphor. 

No. 32. R. Sulphate of Quinine, 8 grains, — Syrup 
of Rhubarb, 2J ounces, — Orange flower Water, 2J 
ounces, — Sulphuric Ether, 10 drops. 

No. 33. R. Muriated Tincture of Iron, 2 ounces. 
Take twenty drops three times a day, in a wine glass 

of the cold infusion of bark. Or, Extract of Bark 

1 drachm, — Extract of Gentian, 1 drachm,— Greti 
Vitriol, J a drachm. — Myrrh, 1 drachm,— Oil of Ani- 



160 Compendium of Domestic Medicine. 

seed, 10 drops, — Simple Syrup sufficient to make the 
whole into a mass, to be divided into sixty pills, of 

which take three twice a day. Or, Rust of Iron, 

1 drachm, — Conserve of Roses, as much as will make 
a mass, to be divided into sixty pills, of which take 
two, three times a day. 

No. 34. R. Calomel, J a drachm, — Tartar Emetic, 
15 grains, — Opium, \ a drachm. Add syrup sufficient 
to form a smooth mass, and divide it into sixty pills. 
No. 35 R. Powdered Borax and Chlorate of 
Potash, of each 1 drachm,— Thymol, 5 grains, — 
Menthol, 1 grain, — Glycerine, 1H ounces, — Al- 
cohol, 2% ounces, — two teaspoonfuls to six tea- 
spoonfuls of warm water; to be used as gargle 
for throat and wash for mouth every two to 
four hours. 
Emollient Clyster. R. Thin Starch, 1 pint, — Mo« 

lasses, 1 wine glassful. Or, Molasses, and Sweet 

Oil, each 1 wine glassful, — Warm Barley Water, 1 

pint. Or, Flaxseed Tea, 1 pint, — Milk, J a pint. 

Anodyne Clyster. R. This is formed by adding 
40 50, 60, or more drops of laudanum (as occasion 
may require) to the Emollient Clyster. 

Purgative Clyster. R. Table Salt and Brown 
Sugur, each a table spoonful, add half a gill of Mo- 
lasses, and rub them well together. While you are 
stirring them, gradually pour in two ounces of Castor 
Oil, and a pint of warm Water. 

Tobacco Clyster. R. Infuse 1 drachm of Tobacco 
in a pint of boiling water for ten minutes. The one 
naif to be injected first, and if this will not produce 
the wished for effect in half an hour, throw up the 
remainder. 

Hartshorne's decoction of Spanish Flies in Spirits 
of Turpentine. R. Spanish Flies bruised, 1 ounce, 
— Spirits of Turpentine, \ a pint. Bcil for three 
hours *nd strain. 



PART SECOND 



EPIDEMIC CHOLERA : 

CAUSES, PREVENTION, SYMPTOMS AND TREATMENT OF 
EPIDEMIC CHOLERA. 



DYSPEPSIA, OR INDIGESTION: 

CAUSES, PREVENTION, SYMPTOMS AND TREATMENT OF 
DYSPEPSIA, OR INDIGESTION. 



S1CK-HEADACH: 

CAUSES, CURE AND PREVENTION OF SICK-HEADACH 

THE TEETH 

STRUCTURE, FORMATION, DISEASES AND 7REATMENT 
OF THE HUMAN TEETH. 



161 



ASIATIC, OR EPIDEMIC CHOLERA. 



As an epidemic, Cholera first made its appearance 
m Bengal daring the month of August 1817. Since 
that period it has continued to prevail, with scarcely 
any intermission, up to the present time, spreading 
itself over nearly the whole of India and the rest of 
Asia, over a part of Africa, and over a considerable 
portion of Europe. In 1832 it broke out in the 
Canadas, and visited successively nearly all the 
larger cities of the United States. By this terrible 
epidemic, provinces have been ravaged, and districts 
depopulated ; entire garrisons have been destroyed, 
and victorious armies arrested in their triumphant 
progress. Under every point of view Epidemic 
Cholera claims the attention of every individual, and 
of every community. Though attended with the 
most violent symptoms, extremely rapid in its progress, 
and in relation to the real cause by which it is pro- 
duced, shrouded in the most impenetrable mystery; 
yet there are few diseases-an attack of which can be 
so readily and certainly guarded against— while no 
one is so completely under the control of medicine 
during its first stages 

163 



164 Compendium of Domestic Medicine 



Cholera, like all other epidemics, is evidently 
dependent upon a morbid change in the condition 
of the atmosphere. What is the actual nature 
of this change it is impossible to ascertain. By 
some it is referred to irregularities in the electrical 
slate of the air ; others have presumed that the air be- 
comes loaded with poisonous effluvia emitted from the 
earth; while others restrict its cause to a change in 
the sensible properties of the atmosphere, in other 
words, to unusual coldness, heat, moisture or dryness 
— or to rapid and sudden transitions in these particu- 
lars. It is certain, that in most places where the 
cholera has appeared, it has been preceded or accom- 
panied by violent storms or earthquakes, or by sea- 
sons unusually disturbed. 

That the disease is in no degree contagious, that 
it is not capable of being communicated from the 
sick to the well, is now established by so many posi- 
tive facts, that it appears unnecessary to enter here 
into an examination of this point. Its non-contagious- 
ness is proved by the disease appearing, at the same 
time, at points far distant from each other ; while in 
situations intermediate between these not a single 
case will occur. Physicians, nurses, and attendants 
upon the sick, are not more affected by the disease 
than other classes of persons, nor even in as great 
a proportion ; and individuals who w r ere in hos- 
pitals with other diseases, and were seized with 
cholera, did not communicate the disease to the other 
patients in their immediate vicinity. 

Predisposing and Exciting Causes. 

1st. A vitiated and damp state of the atmosphere. 
Cholera has always prevailed most extensively and 
produced the greatest ravages, in those situations ordi- 
narily the most unhealthy, particularly in the vicinity 



Asiatic, or Epidemic Cholera. 165 

of low, wet, and marshy districts — along the low, 
muddy banks of rivers; in crowded towns and villa- 
ges, and in the hovels of the poor, where a proper 
ventilation is neglected, and in which all kinds oi 
filth are allowed to accumulate. 

2d. A constitution broken down by misery, vice, 
intemperance or fatigue. In every place where 
Cholera has made its appearance, the great majority 
of those attacked have been individuals of the lowest 
classes of the community ; those living in the depths 
of vice and misery ; the habitually intemperate ; those 
who were constantly exposed to fatigue, and to the 
inclemencies of the weather ; and those who, from 
extreme poverty, are obliged to subsist on unwhole- 
some food, or such as is deficient in nutriment. But 
few persons in easy circumstances and of temperate 
lives have been attacked ; and in those few, the oc- 
currence of the disease could very generally be 
traced either to fatigue, to exposure to wet or damp 
or to the night air, to fear and anxiety, to improper 
food, as that which is too stimulating, difficult of 
digestion or flatulent, to fasting too long, to a consti- 
tution broken down by disease or a state of conva- 
lescency particularly from stomachic and bowel 
complaints, to the use of impure water, of cold and 
iced fluids or of iced creams when the body is in a state 
of fatigue, or overheated.to indulgence in acid drinks, 
or those which readily become sour in the stomach, 
as the weaker wines, table beer, cider, &c, to the 
imprudent use of medicine, especially emetics and 
purgatives, or to prolonged watchfulness 



PREVENTION. 

To avoid Cholera, therefore, an individual must 
live temperately on plain, nutritive food, simply 
cooked. He must avoid rich, high-seasoned soups 
and sauces, all made dishes and pastry; of salted 
provisions he must partake in great moderation, 



166 Compendium of Domestic Medicine. 



salted, dried, and smoked fish he must abstain 
from, as also pork, geese, ducks, crabs, lobsters, and 
the like. He must avoid all flatulent vegetables, as 
cabbages, radishes, green corn, dried peas and beans 
or those difficult of digestion, as mashed potatoes, 
cucumbers melons, mushrooms, pickles, &c. and 
likewise all unripe, decayed, or very acid fruit. He 
must give up entirely the use of ardent spirits, bran- 
died wines, &c. as ordinary drinks : indeed, as a 
general rule, pure water should be his sole beverage. 

Active regular exercise in a free pure air, not carried 
so far as to induce fatigue ; regular and sufficient 
sleep; the avoidance of crowded assemblies, of the 
night air, of wet or damp, or extreme heat, or of ex- 
posure to cold, without due precaution, are other 
means essential to be observed, in order to escape an 
attack of Cholera. 

Personal cleanliness, and all the other means cal- 
culated to insure the due performance of the functions 
of the skin, are likewise all important preventives ; 
hence the use of the warm bath daily, or sponging 
the entire surface with tepid water, followed by brisk 
frictions, morning and evening, and a flannel or thick 
cotton garment next the skin, should never be neg- 
lected. 

The possession of that species of moral courage 
which is intimately connected with a well informed 
mind ; a reliance upon the goodness and superin- 
tending providence of the Supreme Being; and a 
consciousness of having fulfilled, to the utmost of 
our abilities, our religious as well as social duties 
(which, while they prompt us to avoid danger by 
the use of all practicable and rational means, pre- 
vent all unnecessary terror and alarm when the 
evil is present), have a powerful influence in guard- 
ing the system against disease during the prevalence 
of every epidemic. 

The necessity of comfortable, clean and well ven- 
tilated dwellings, situated in a dry, elevated and 
otherwise healthy situation, must be sufficiently 



Asiatic, or Epidemic Cholera, 167 

evident to all. When, however, an individual is 
under the necessity of residing in a low, damp, 
unhealthy situation, much may still be done to pre- 
vent disease, by a proper attention to ventilation, 
during fine weather; by strict cleanliness; by closing 
th* doors and shutters before night fall ; by occupy 
ing the upper rooms of the house, and, in very damp 
weather, by fires in the apartments where the family 
pass the day, and in the bed-chamber. 



SYMPTOMS. 

Epidemic Cholera, in regard to its symptoms, may 
be divided into four stages or periods 

1. The Stage of Diarrhoea. • 

This stage is usually accompanied with griping 
pains in the stomach and bowels; by a sense of lassi- 
tude ; rumbling of wind in the bowels ; frequently, 
pain and giddiness of the head, and dull pains in the 
knees and loins. The pulse is various; the tongue is 
coated with a thin white or yellowish mucus, or thickly 
furred in the centre and red at the edges. The appe- 
tite is diminished ; and the thirst increased. There are 
often shooting pains or stitches through the calves ui 
the legs. The foregoing symptoms are most usually 
attended with nausea, with frequent watery dis- 
charges from the bowels, or with a constant inclina- 
tion to go to stool without any evacuation taking 
place, or with only a thin mucous discharge some- 
times streaked with blood. This stage may last for 
several days before the symptoms of the ensuing 
stage are developed ; in many cases the symptoms of 
the latter appear in a few hours. . The occurrence of 
the second and subsequent stages depends greatly 
upon the constitution and habits of the patient, as 
well as upon the circumstance of his having, or not 
resorted to proper medical aid. In the debilitated 
and especially the intemperate, the discharges from 



168 Compendium of Domestic Medicine. 

the bowels are not unfrequently from the first very 
copious, of the appearance of whey, and giving rise 
to a sense of extreme exhaustion, of faintness or even 
fainting In such cases, in a very few hours, cramps, 
vomiting and collapse are apt to come on ; any im- 
prudence in eating or drinking, improper exposure, 
&c. will also accelerate the occurrence of the second 
and subsequent stages of the disease 

2. The Stage of Spasm. 

This stage is characterized by violent pains of th0 
stomach and bowels occurring at intervals ; by pain of 
the head and back ; by almost incessant vomiting and 
purging of a rice-water fluid ; by inordinate thirst and 
violent spasms, particularly of the muscles of the ex- 
tremities. The skin still remains warm, but is bathed 
with perspiration, and has a peculiar doughy feel ; the 
tongue presents nearly the same appearance as in the 
first stage ; the temperature of the hands and feet is 
reduced ; the pulse is often full and of some firmness ; 
in other cases it is very compressible ; or again, it is 
small and contracted. The mental faculties are un- 
impaired; the countenance is expressive of great 
suffering or distress. In this stage the secretion of 
urine is often diminished in quantity or entirely sus- 
pended. 

3. The Stage of Commencing Collapse. 

In this stage the skin is cold, livid and covered wi 
a profuse clammy perspiration ; the tongue is also col 
and livid; and the extremities corrugated as if they had 
been soaked in water; there are freq uent cramps of the 
extremities; the eyes are sunk, the features contracted; 
there is constant purging, occasionally accompanied 
with vomiting ; there is pain of the stomach, a small, 
feeble and depressed pulse, and a complete suppress- 
ion of the urinary secretion. The mental faculties 
are still unimpaired. Often considerable heat is felt 
over the stomach. Great thirst and a constant desire 
for cool air are almost invariably present. 



Asiatic, or Epidemic Cholera. 169 

4. The Stage of Confirmed Collapse. 

This stage is marked by icy coldness, and a deep b. ue 
or purple hue of the skin, tongue and inside of the 
mouth ; the extremities are corrugated ; the whole sur- 
face is covered with a profuse cold perspiration, which 
seems to exude in large drops from the pores of the 
skin. No pulsation can be detected in any of the su- 
perficial arteries, and the action of the heart is slow 
and feeble. Involuntary watery discharges flow from 
the bowels. The voice is low, husky, and almost 
extinct. The body exhales a peculiar and very dis- 
agreeable odour. There is a short quick respiration, 
with heaving of the chest. The patient complains of 
a burning heat in the region of the stomach, and craves 
without intermission cold water and fresh air; he is 
extremely restless, or doses with half open eyelids, 
the pupils of the eyes being rolled very much up 
wards. Until the very end, the mental faculties 
continue unimpaired. 



TREATMENT. 

The treatment of Cholera differs according to 
the stage of the disease. 

1. In xhejirst stage, when the patient is young and 
robust, the skin dry, the pulse frequent and hard, and 
the griping pains in the bowels constant or severe; 
a large mustard plaster over the abdomen, and 
another on the back, will be found of great service. 
Bathing the feet in warm water, also the applica- 
tion of frictions to the whole of the lower extrem- 
ities, or mustard poultices to the ankles, will also 
be decidedly beneficial. 

When the diarrhoea is but trifling, a dose of cam- 
phor with a few drops of laudanum should be 
given, and repeated if necessary. 

If the discharges from the bowels are very co- 
pious, and of a thin, watery and unnatural appear- 
ance, a pill of camphor, rhei and opium, repeated at 



170 Compendium of Domestic Medicine. 

proper intervals, will often be found very speedily 
to arrest these discharges, and after a time to pro- 
cure the evacuation of a very dark, viscid and 
offensive matter, followed by natural stools. 

When the griping and constant inclination to 
stool are peculiarly troublesome, place lumps of 
ice continually on the tongue, and an injection of 
thin starch, olive oil and opium will often remove 
very speedily the disease. The warm bath is a 
remedy well adapted to this stage when properly 
managed. 

Attention to diet and clothing is all-important. 
The patient should be confined exclusively to gum 
or rice water taken cold and in small quantities 
at a time; even after the symptoms of the disease 
have disappeared, the diet should consist for sev- 
eral days of well boiled oat meal gruel, thickened 
milk, or crackers boiled in milk. A very slight 
impropriety in diet will often bring back the very 
worst symptoms of the complaint, and render a 
cure impossible. 

2. When Cholera has reached its second stage, 
there is not a moment to be lost — the least delay 
on the part of the patient, or timidity in the prac- 
titioner will be followed by the most fatal conse- 
quences. Give the patient every five minutes a 
dose of the following anodyne and cordial tinc- 
ture : Take of aromatic spirits of ammonia, lau- 
danum, chloroform and spirits of camphor 1£ 
fluid drachms, creosote 8 drops, oil of cinnamon 
2 drops, alcohol enough to make 1 oz. of the tinc- 
ture. Put a tea-spoonful of this in a wine-glass 
of ice water, and give one tea spoonful of the so- 
lution every five minutes until the patient decid- 
edly improves, then lengthen the intervals of 
doses till the symptoms all abate. This treat- 
ment, the result of much experience during the 



Asiatic, or Epidemic Cholera. 171 

visitation of the cholera in 1849, 1850, and 1854, 
has been found very successful. 

The limbs of the patient should then be rubbed 
well with some stimulating liniment : these fric- 
tions are to be followed by mustard poultices to 
the ankles, wrists, thighs and arms. In this 
stage, particularly at its very commencement, 
bathing the feet in hot water will frequently be 
followed by a very good effect, 

Internally the patient should take iced water in 
small portions at a time ; or when this is immediately 
rejected by the stomach, a tea-spoonful of powdered 
Ice may be given every fifteen minutes. After the 
stomach has become calm and is capable of re- 
taining medicine, the pill of camphor and opium, 
as directed in the first slage, should be given, and 
repeated every two, three or four hours according 
to circumstances. 

By this treatment, in a very short period, the vomit- 
ing and spasms will be suspended, and the inordi- 
nate discharges from the bowels arrested. In many 
cases a dose of castor oil will now bring away copious 
stools of a very dark and extremely offensive nature, 
after which the bowels will return to their natural 
condition. 

It is all important in this stage to prevent the 
patient from drinking too much ; which, in conse- 
quence of his inordinate thirst, he will be very apt 
to do unless carefully watched. The warm and 
vapour baths do no good, but rather harm in the se- 
cond stage of Cholera ; and the most pernicious effects 
will in general result, if recourse be had to stimu- 
lants, or to inordinate doses of opium or lauda- 
num. 

Occasionally it will be founl that there is a ten- 
dency in this stage to an overloaded state of the 
vessels of the brain, indicated by drowsiness, dilated 
pupil, and a dark flushed appearance of the coun- 
tenance ; here, cups to the temples or back of the 



172 Compendium of Domestic Medicine. 

neck, with cold applications to the scalp, should 
never be neglected. 

3. When Cholera has reached its third stage, to 
save the life of the patient will demand great cir- 
cumspection, judgment, and decision on the part 
of the physician and attendants. The entire sur- 
face of the patient should be diligently rubbed 
either with the hand, or a flannel cloth, wet with 
a liniment composed of equal parts of spirits of 
turpentine and a solution of pure ammonia; after 
the frictions, large mustard poultices should be 
applied to the arms, wrists, thighs and ankles; 
and the feet should be enveloped in bags filled with 
warm bran or sand, and the whole body covered 
with a blanket. 

By the treatment just detailed, the reduction of 
the symptoms is produced gradually : first there is 
a cessation of the profuse perspiration ; the fea- 
tures then become more natural, the corrugation 
of the extremities disappears, and finally the livid 
colour of the skin is removed and the natural tem- 
perature of this part is restored. 

Throughout the third stage of Cholera the pa- 
tient should be supplied, at short intervals, with 
small quantities of powdered ice or of iced water. 
Even greater caution than in the second stage, 
will be required to prevent him from indulging 
his inordinate thirst; to guard him against the use 
of stimulants, and the too free administration of 
opiates. In the early period of this stage all kinds 
of food are to be abstained from : when conva 
lescence has been established, the same remarks 
in regard to diet will apply as were made in refer- 
ence to the first stage. 



Asiatic, or Epideuic Cholera. 173 

4. When the period of confirmed collapse has 
arrived, little hopes of recovery need be enter- 
tained. The patient should be carefully rubbed 
over the whole body with ice, then dried and 
wrapped in dry blankets outside of which bags 
filled with warm bran or bottles of hot water may 
be applied, and internally give champagne and 
ice, or rum and Selters water, or one gr. camphor 
every \ hour, or spirits of hartshorn one drachm 
in 6 oz, sugar water, a table-spoonful every \ to \ 
hour. Also rub the body with spirits of mustard, 
and for the cramps in the calves of the legs rub 
them with chloroform and camphor spirits. 

As soon as reaction takes place and has been 
fully established, the treatment should be con- 
ducted as in the other stages. In the period of 
reaction let the patient sleep and perspire freely, 
and continue giving him Selters water and ice. 
To arrest the discharges from the bowels, give 
\ gr. calomel every 3 hours with or without opium ; 
if vomiting should take place, give small doses 
of morphium 1-15 gr.,— and a mustard plaster 
over the stomach,- if there is a tendency of con- 
gestion to the head, apply cold iced cloths or 
leeches. After recovery, the patient must natu- 
rally be very careful for a long tin e with his diet. 



174 Compendium of Domestic Medicine. 



DYSPEPSIA, OR INDIGESTION. 



There are few complaints more prevalent, parti- 
cularly among sedentary mechanics and artizans, 
students and professional men generally, as well as 
among the indolent and luxurious inhabitants of all 
large and wealthy cities, than those which have 
their origin in the stomach and the other organs con- 
cerned in digestion. The stomach and intestinal 
canal, parts of a most delicate structure and possessed 
of an exquisite sensibility, are not only hourly subject 
to injury from improper food and drinks, or an excess- 
ive indulgence of the appetite in a diet, which, if 
laken in moderation, would be altogether whole- 
some ; but, by the close sympathy which exists be- 
tween these and all the other organs, they quickly 
participate in the diseases of other and remote parts. 
Whether it be the brain, the lungs or the skin which 
suffers, the stomach cannot remain long in health. 
Hence, Indigestion is an attendant upon nearly every 
malady, both acute and chronic, to which the human 
body is liable. The symptoms of pain and uneasi- 
ness in the region of the stomach are often indeed 
the first which direct the attention of the patient to 
his real condition. On the other hand, the extensive 
sympathies of the stomach cause the diseases which 
may originate primarily in the latter to be extended 
quickly to the liver, bowels, brain, skin and lungs 



Dyspepsia, or Indigestion, 175 

It is this that renders indigestion so complicated and 
protean a disease— differing in its phenomena accord- 
ing to the period that it has existed and the constitu- 
tion, age and sex of the patient in whom it occurs. 



CAUSES. 

The causes of Dyspepsia are of two classes. First, 
those which affect primarily the stomach; and se- 
condly, those which disorder first some other organ, 
the stomach being affected secondarily or by sym 
pathy. 

Of the causes which affect directly the stomach, 
the principal are errors in eating and drinking 
Overfeeding, the use of too rich and stimulating food, 
of articles difficult of digestion, as fried meats, made 
dishes, gravies, clams, lobsters, fried oysters, rich 
soups, fresh bread, and pastry of all kinds; late and 
heavy suppers, eating rapidly without properly 
chewing the food, the excessive use of strong tea and 
coffee, the use of flatulent and indigestible vegeta- 
bles and fruits, as cabbage, green com, pickles, 
cucumbers, melons and the like, and the abuse of 
spices, are so many causes of injury to the digestive 
organs, and which, sooner or later, give rise to the 
train of symptoms characteristic of Dyspepsia. Ex- 
ercise immediately after eating, or intense occupation 
or violent excitement of the mind, if constantly or 
repeatedly indulged in, by impeding the change of 
the food into chyme, and allowing it to ferment or 
become acrid, will always, sooner or later, induce 
Dyspepsia. All drinks excepting water, used as 
ordinary beverage, whether fermented or distilled, 
malt, vinous or spirituous, disorder the digestive or- 
gans, and give rise to the very worst kinds of 
dyspepsia. The tippler as well as the drunkard are 
almost invariably dyspeptic. Even lemonade, if 
drank ir too great quantities or too frequently, will 
disorder, n variably thr stomach Smoking, chewing 



176 Compendium of Domestic Medicine. 

and even constant snuffing, very generally produce 
Dyspepsia, as well by the waste and vitiation of the 
saliva, as by the narcotic or depressing effect which 
the tobacco produces upon the nervous system gene- 
rally, or immediately upon the stomach. When, by 
any of these causes, the coats of the stomach are 
rendered morbidly irritable and its vital powers are 
impaired, the use of even the ordinary articles of 
food will be a sufficient stimulus to increase the 
disease, and dev elope the more aggravated phe- 
nomena of Dyspepsia. A cause of Indigestion which 
acts primarily upon the stomach and bowels, of not 
unfrequent occurrence, though but little suspected, 
is the imprudent or immoderate use of various 
medicines. 

Any indiscretion— whether it consist in excessive in- 
dulgence in food, an occasional debauch or a too heavy 
supper — will give rise to certain symptoms termed 
in popular language bilious. Now the most prudent 
course would be abstinence for a day or two with 
the plentiful use of some bland diluent. But instead 
of this, resource is had to an emetic, to a dose of 
calomel or anti-bilious pills, followed perhaps by 
chamomile tea, or some aromatic tincture or stomachic 
bitter, or perchance a daily glass of brandy and 
water ; and the slight irritation which exists in the 
stomach is in this manner not only aggravated but 
rendered permanent, and Dyspepsia ensues. 

Of the causes which act indirectly upon the 
stomach in the production of Dyspepsia, the principal 
are, the want of sufficient active exercise; exposure 
to a damp, vitiated and confined atmosphere ; seden- 
tary and constrained positions of the body long in 
dulged in ; close application or anxiety of the mind, 
together with all the exciting and depressing passions; 
late rising and prolongation of the occupations or 
amusements of the day during the greater part of 
the night; want of cleanliness, or rather inattention 
to the state of the skin; frequent vicissitudes of the 
weather; cold and damp; and a neglect to obey the 



Dyspepsia, or Indigestion. 177 

regular calls of nature for the evacuation of the 
bowels — excessive indulgence in venereal pleasures 
and various unnatural practices. 

In casting the eye over the above list of causes, the 
reason will be readily understood why Dyspepsia is 
of so frequent occurrence among nearly all the 
classes which compose the population of a large city. 

The sedentary artizan confined for the greater part 
of the day and night to a small, close, and often dirty 
and crowded workshop, his body bent constantly 
over his task, while his mind perhaps is harass- 
ed by the anxious thoughts occasioned by the wants 
of a numerous family immersed in poverty, or the 
painful reflections to which a view of his own folly 
may have given birth — The slave of luxury or of 
pleasure, whose whole existence is spent in listless 
apathy or in a round of dissipation, w T ho consumes 
the night amid scenes of riot or of folly, and the 
morning in uiirefreshing slumbers or in entire in- 
dolence — The industrious mechanic and shop-keep- 
er, whose minds are absorbed by the cares of exis- 
tence and their bodies imprisoned within the narrow 
confines of their respective shops — The enterprising 
nerchant, the ambitious student, the aspiring poli- 
tician, the man of letters and the members of the 
various professions, who, in addition to their seden- 
tary habits, have a thousand causes to vex and agitate 
their minds, and too often add to these, errors in 
diet and indulgence in intoxicating drinks— Finally, 
the numerous slaves of vice and sensuality pro- 
duced by the folly, and nurtured by the wealth of 
every prosperous and crowded city: These all era 
stitute so many victims to Indigestion, as well as to 
numerous other diseases. 

Those most exempt from diseases of the stomach 
are individuals of temperate habits and contented 
minds, whose inclinations or whose occupations 
carry them abroad into the open air and impose a 
necessity for active and regular bodily exercise 
T'^e employments most friendly to health of stomael 
M 



178 Compendium of Domestic Medicine. 

and of the body generally, are those of the farmer, 
and the gardener, who at the same time adhere to 
regular hours and sober habits, and are removed at 
once from the deteriorated and unwholesome atmos- 
phere and follies of the city, and the thousand sources 
of care and anxiety to which its inhabitants are daily 
subjected. 



SYMPTOMS. 

The symptoms of Dyspepsia are very numerous 
and diversified — they differ according as the disease 
is confined to the stomach and bowels, or has ex- 
tended to the liver, the brain, the skin, the lungs and 
other organs. The phenomena by which the disease 
is most usually accompanied, are a sense of disten- 
sion or oppression after eating, acrid or sour eructa- 
tions, flatulence with frequent belching of wind, 
impaired appetite, vitiated taste, increased thirst, 
constipation and uneasiness of the bowels, sometimes 
looseness, coated tongue especially in the morning, 
loss of strength, disinclination to exercise, and a 
general feeling of depression and indescribable 
weariness. When the bowels are moved, the stools 
are unnatural, being either green, black or very light. 
Nausea, headach, vertigo and dimness of vision are 
very generally experienced, and sometimes bilious 
vomiting; a burning sensation at the pit of the 
stomach is not unfrequent; sometimes the patient 
experiences a violent pain of the stomach which ter- 
minates by a copious discharge, by the mouth, of an 
insipid or perhaps intensely acid, colourless fluid of 
a glairy consistency. Palpitation of the heart likewise 
often attends; with pain in the pit of the stomach or 
towards the right side, sallowness of complexion, 
depression of spirits and irritability of temper. The 
patient is sleepless at night and drowsy during the 
day, or his slumbers are disturbed by the most 
frightful or distressing dreams. Sometimes the body is 



Dyspepsia, or Indigestion. 179 



extremely emaciated, at others it appears fat or rather 
bloated. The whole of the foregoing symptoms are 
not, however, present in every case of Dyspepsia ; 
but under whatever form, and from whatever cause 
the disease has originated, there is always a conside- 
rable degree of general languor and debility, and a 
great susceptibility to atmospherical vicissitudes; 
exercise, or exertion of any kind soon fatigues; the 
pulse is weak or morbidly excited, the sleep disturbed, 
the limbs, especially the feet are cold, or rendered 
so by slight causes ; and a sense of distension and 
oppression, acid eructations, flatulence, nausea, head- 
ach, irregular bowels, pain in the pit of the sto- 
mach, sallowness of the complexion and dryness of 
the skin are pretty constantly present. 

Frequently there is a good deal of feverish heat, 
with flushing of the face, dryness of the mouth, thick 
coated state of the tongue, pain on pressure at the 
pit of the stomach, weakness of the knees, wandering 
pains of the limbs and body, and a dry scurfy state 
of the whole surface. 

In the more aggravated forms of Dyspepsia there is 
often constant violent pain in the stomach; frequent 
vomiting of dark matter, the utmost debility and 
emaciation of body, and extreme despondency of 
raind. In others there are cough and expectoration, 
hectic fever, night sweats, and a wasting diarrhoea. 

Frequent and dangerous mistakes are often made 
H relation to the seat and real nature of the disease 
p -in<r rise to the symptoms of Dyspepsia. The bitter 
taste in the mouth, nausea, bilious stools and sallow 
complexion, have led many to ascribe them to a 
disease of the biliary organ — hence it is not unfre- 
quent to hear dyspeptic patients complain of being 
bilious or of suffering from liver complaint. But 
though in very many cases the biliary secretion is 
disordered, yet for the most part this is a secon- 
dary and sympathetic affection, dependent upon the 
irritation or disease seated in the stomach and upper 
portion of the intestines, and quickly disappears upon 



180 Compendium of Domestic Medicine. 

the removal of the latter The practice resorted to 
under the supposition of bilious derangement being 
the chief cause of the symptoms, is highly pernicious, 
very generally aggravating and complicating the 
primary disease. Emetics, frequent doses of calomel 
and other purgatives, and the various irritating reme- 
dies so generally employed, always do more or less 
injury to the already diseased stomach. 

Other patients, paying attention solely to the sense 
of exhaustion, the disinclination to exertion, the want 
of appetite and the sallowness of the complexion, 
believe the whole of the symptoms under which they 
labour to be the result of pure debility. Tonics, 
stimulants, wine, brandy and porter with rich nour- 
ishing food are resorted to, but without the least good 
effect. The disease proceeds onwards even more 
rapidly than before, and the mistaken patient becomes 
daily more and more weak. The remedies he has 
taken have acted like oil thrown upon fire : instead 
of removing the debility of the system they have 
merely increased the irritation of the stomach, and 
secondarily of the other organs. 

By others again the symptoms of Dyspepsia are 
supposed to be nervous ; and valerian, ether, musk, 
assafcetida and bark are profusely administered to 
relieve them, by strengthening, as it is presumed, the 
oervous system. It is very certain that many of the 
symptoms from which dyspeptics very commonly 
suiter dc-p^id upon an affection of the nervous 
system; bur the treatment usually resorted to, in 
order to remove such affection, is altogether impro- 
per, it keeps up and aggravates the disease of the 
stomach by which the nervous affection has been 
produced 



PREVENTION. 

The prevention of stomachic diseases, including 
Dyspepsia, will depend upon a cautious avoidance of 




ALIMENTARY CANAL. 

a, oesophagus; b, stomach ; c, cardiac orifice; d, pylorus: 
e, small intestine ; /, biliary duct; g, pancreatic duct ; 
h, ascending colon; t, transverse colon; j, descending 
colon ; k, rectum. 



Dyspepsia, or Indigestion. 181 

their remote and exciting causes. Let an individual 
live upon plain wholesome food, cooked in the 
simplest manner and eaten in moderation. Let him 
drink nothing but water, and allow to his meals a 
sufficient space of time, so that he need not eat with 
haste, and swallow his food without properly chewing 
it. Let him shun crowded, ill ventilated apartments, 
and take a sufficient amount of active exercise in the 
open air daily. Let him retire to rest at an early 
hour at night, and rise from his bed with the sun. 
Let him make no use of tobacco in any form. Let 
him cultivate an even, contented and cheerful frame 
of mind, and shun as much as possible every source 
of engrossing care, and of deep depressing emotions 
* Living wisely," as an old writer justly expresses it, 
" rather in the shade, than risking his happiness upon 
the smiles and the whims of fickle men ;" let him 
fly from dissipation, folly and vice of every kind, and 
he will seldom be troubled with Dyspepsia. 



TREATMENT. 

The first and most important point in the treat- 
ment of Dyspepsia is to relinquish whatever cause 
has laid the foundation for or given rise to the 
complaint, and which continues to aggravate it. 
This will of itself often be sufficient, especially in 
its early stages, to remove entirely the disease. If 
the patient leads a fashionable life, it will be neces- 
sary for him to forsake at once the haunts and habits 
of dissipation; to leave the crowded city, to shun 
luxurious tables, rich wines, strong drinks and late 
suppers ; to renounce his indolence and late hours ; 
and to return to a simple and rational mode of living. 
He must seek pure air, engage in active regular ex- 
ercise and in pleasing out-door occupations, retire 
and rise early, make use of a simple moderate diet, 
and court the society of a few cheerful and intelligeni 
friends. The plodding student must in a great mea- 



L82 Compendium of Domestic Medicine. 

s ire lay aside his books, and extinguish his midnight 
lamp ; the fagging tradesman and merchant will find 
it indispensably necessary to seek daily, active exer- 
cise in a pure air; the tippler and the drunkard must 
give up their potations. In short all dyspeptics must 
exercise for several hours each day out of doors ; they 
must rise early and take a sufficiency of sleep during 
the night; they must seek cheerful conversation; and 
carefully and constantly observe a moderate, plain 
and wholesome diet. 

Among the articles from which the individual 
labouring under Indigestion must entirely abstain 
are to be included all species of very fat, salted, 
dried, smoked or fried animal food ; veal in almost 
any form, rich soups and sauces, spices, pickles, 
cucumbers, all flatulent vegetables, particularly cab- 
bage, mashed potatoes, melons, unripe fruit, also sau- 
sages, fish, particularly salted fish and that which is 
fried, fresh bread, hot toast, pastry, fried oysters, crabs 
and lobsters, animal jellies, tea, coffee, malt liquors, 
wine, ardent spirits, and tobacco whether in snuffing, 
chewing or smoking. 

The dyspeptic should never take so much food at 
one meal as to cause a feeling of fulness or distension 
in the stomach; and, except under very particular 
circumstances, he should confine himself to three 
meals a day; the last one to be taken at least two 
hours before going to bed, and to be very light. 

The best common beverage for a dyspeptic is pure 
water, or toast and water. 

It is a common but very erroneous opinion, that 
persons with impaired appetites and feeble powers 
of digestion ought to eat little at a time and often. 
Such a practice is altogether injurious. By taking 
food in small portions almost constantly, no time is 
allowed for the proper digestion of that previously 
eaten, and the stomach is in this way kept in a 
constant state of activity and of irritation. In- 
stead of gaining strength, it becomes more enfeet> 
.ed. As a general rule, subject to very few ex 



Dyspepsia, or Indigestion. 183 

ceptions, no food should be taken in the intervals of 
the meals. 

Riding on horseback is a highly beneficial exercise 
for those labouring under Indigestion; it gives a mo- 
tion to the abdominal organs, which is communicated 
by no other kind of exercise. Daily walking in the 
open air must not however be neglected. A combi- 
nation of these two species of exercise is preferable 
to either alone; for riding chiefly exercises tne 
abdominal viscera, and walking the limbs and thora- 
cic organs. Exercise should never be taken imme- 
diately after a meal, nor carried to the extent of 
inducing undue fatigue. 

The feet, chest and abdomen of dyspeptics should 
be especially guarded from cold. If there is consi- 
derable torpor of the skin and a feeling of chilliness 
from slight reductions of temperature, flannel should 
be worn next the skin, during at least the colder and 
more changeable months of the year. Woollen 
stockings and a flannel roller around the abdomen 
are always important articles of dress to the dyspep- 
tic. At night, the bed clothes should not be more 
than are sufficient to keep the body comfortably 
warm, and a mattrass is always preferable to a 
feather bed. 

The following are the principal symptoms which 
seem to demand relief in Dyspepsia. 

1. Costiveness. 

There are few points of greater importance in the 
management of Dyspepsia than the proper regu- 
lation of the bowels. They ought to be fully eva- 
cuated once in the twenty-four hours. To do this, 
the habit of soliciting a discharge at a regular period 
of the day by the natural efforts will often suc- 
ceed. Habitual costiveness in those inclined tc 
indigestion is often caused by neglecting the calls of 
nature. If this have not the desired effect, a diet 
composed of laxative vegetables, as well-toiled spin- 



184 Compendium of Domestic Medicine. 

nage, boiled turnips squeezed perfectly dry, well* 
boiled oat-meal gruel, chicken or veal broth, or some 
of the summer fruits, perfectly ripe, eaten raw or aftei 
being cooked, will very generally produce a free 
state of the bowels. Let it be recollected that 
although the articles of food just enumerated maybe 
highly improper for the ordinary use of the dyspeptic, 
yet taken occasionally, merely with a reference to 
their laxative effects, no harm but much good will 
result from them. Bran bread or crackers, used con- 
stantly, will often remove costiveness. If costi veness 
still continue in conjunction with regular active ex- 
ercise and early rising, frictions over the whole of 
the abdomen night and morning should be resorted 
to. The practice of shampooing, rendered some time 
since very popular in this city by the announcements 
and publication of Mr Halsted, will not unfrequently 
succeed in causing regular evacuations by stool, and 
obviate the necessity of resorting to medicine. This 
practice will be detailed hereafter. The use of the 
warm bath should never be neglected. When me- 
dicines are demanded, they should be of the most 
gentle kind and not too long persisted in. A combi 
nation of magnesia, rhubarb and small portions of 
ipecacuanha is a very excellent purgative in dyspep- 
tic cases ; so are the seidlitz powders, if not too often 
repeated. A pill composed of the blue mass, soap, 
myrrh and ipecacuanha, will be in many cases pre- 
dictive of the best effects The utmost care must 
be observed, however, not to produce active purging 
or any considerable irritation of the bowels, in 
attempting to relieve costiveness — whatever remedy 
is used, its effects are merely temporary; a regular 
state of the bowels can be obtained permanently in 
no other way than by a proper diet and regimen, in 
addition to the other means calculated to restore to 
"he digestive organs their healthy tone and functions 



Dyspepsia, or Indigestion. 18f 



2. Flatulence. 

To remove this unpleasant and troublesome symp 
torn, strict attention must be paid to diet. Food 
m any degree irritating, acid or fermentable must 
be abstained from. Active exercise must be taken 
in the open air, and frictions over the stomach re- 
peated several times a day. As a palliative, a 
glass of water in which a few grains of the bi- 
carbonate of soda have been dissolved, or perhaps 
what is better with the addition of a few drops of 
aqua ammonise, will often be found useful. There is 
danger however of increasing the irritation of the 
stomach when this is too often repeated. The cause 
of flatulence is the disordered state of the digestive 
organs ; when this is remedied the former will cease. 
We must caution the dyspeptic against the too cus- 
tomary practice of resorting in cases of flatulence to 
mint water and various aromatic tinctures, brandy 
and water, and similar stimulants : from such remedies 
the most mischievous effects are to be apprehended. 

3. Violent Pain of the Stomach and Bowels. 

In some cases of Dyspepsia the paroxysms of pain 
are so intense that for their immediate relief opium 
must be resorted to ; the best form for its administration 
will be in the form of a powder composed of one grain 
of opium or one third of a grain of sulphate of morphia 
with ten grains of magnesia and one of ipecacuanha. 
The relief obtained in this way, however, is only 
temporary ; and to repeat too frequently the remedy 
will be productive of mischief. The calm resulting 
from opiates in Dyspepsia very often leads to their 
habitual use; but this never fails to aggravate the 
disease and render its cure more difficult, if not im- 
possible. Ten grains of pepsin with three grains 
of the subnitrate or carbonate of bismuth, taken 
before each meal, will be found of very great 



186 Compendium of Domestic Medicine, 

benefit in these cases. In very many cases 
the pain of the stomach will be removed by 
warm fomentations over the abdomen, and by cupi 
to the region of the stomach or along the spine. 

4. Nausea and Vomiting. 

Nausea and vomiting are often distressing symp 
toms in cases of Dyspepsia. To relieve them, cold 
toast water, or a draught of soda water taken in a 
state of effervescence, will very commonly be found 
useful remedies, in conjunction with a proper atten- 
tion to diet. When the vomiting is very distressing, 
a blister should be applied over the pit of the sto 
mach. 

5. Constant Soreness and Pain of the Stomach, 

Soreness of the stomach, great tenderness under 
pressure, or constant pain in that organ, is frequently 
present in protracted cases of Dyspepsia. It is some- 
times accompanied with burning of the soles of the 
feet and palms of the hands, or dryness and heat of 
the entire surface. In these cases the use of all 
solid food must be abandoned, the patient being con- 
fined solely to toast water or gum arabic tea,* ice 
bladders or cloths dipped in cold spring water and 
wrung out, should be applied without delayover the 
stomach, and repeated if the symptoms be not removed 
the first time, or if they recur subsequently. The 
patient should not in such cases make use of any 
very active exercise. The pain and tenderness 
alluded to depend upon a greater or less degree of 
inflammation seated in the lining membrane of the 
stomach and upper intestine; which, unless it be 
promptly removed, may produce a degree of disor 
anization in these important organs from which re 
coverv ean scarcely be huped for. 




CHYLE-YESSELS OF THE MESENTERY. 

1, aorta; 2, thoracic canal ; 3, lymphatics; 4, radicles of 
the chyle- vessels ; 5, intestine ; 6, mesentery ; 7, 
lymphatic vessels. 



Dyspepsia, or Indigestion. 18? 



GENERAL REMEDIES. 

We have next to consider some general remedies 
demanded for the cure of Dyspepsia. 

1. The Warm Bath and Frictions. 

So intimately connected are the stomach and skin, 
that one of these parts can scarcely ever be involved 
in disease without the other suffering likewise. It 
is important therefore, in all cases of Indigestion, to 
promote the health of the external covering of the 
body — by exciting it to a regular discharge of its 
functions. This is best effected by the use of the 
warm bath and by frictions. When properly used, 
these means seldom fail to prove highly refreshing, 
to remove many of the symptoms most distressing to 
the patient, while they aid greatly in bringing back 
the digestive organs to a healthy condition. From 
ninety to ninety-six degrees is the best range of heat 
of the bath for the use of dyspeptics ; and the proper 
time for resorting to it is in the morning, between 
breakfast and dinner. The patient may repeat the 
bath three or four times a week, and remain in it 
from fifteen to thirty minutes, according to his feel- 
ings, which ought to be comfortable on coming out 
of the water. A gentle walk or ride should follow 
the use of the bath whenever the weather is favour- 
able. When the warm bath cannot be conveniently 
procured, or when it fails in producing a beneficial 
effect, which will seldom however be the case, tepid 
sponging may be substituted. That is, the whole 
surface of the body is to be sponged regularly every 
morning with tepid water, or salt and water ; the pa- 
tient immediately afterwards rubbing himself per- 
fectly dry with a coarse towel. This is a very 
refreshing and beneficial practice, and one which 
•Sir Astley Cooper considers to have very materially 



188 Compendium of Domestic Medicine. 

contributed to ensure the excellent health which he 
so long enjoyed. He uniformly resorted to it imme- 
diately on rising from his bed. Frictions over the 
surface with a towel or flesh brush without sponging 
may also be resorted to with the best effects in the 
evening, or just before retiring to bed. This is a 
very effectual means for producing sound and re- 
freshing sleep, and causes the patient to awake in 
the morning with renewed strength and vigour. 

2. Mr Halsted's Method. 

On principles similar to those on which the warm 
bath and frictions act, in removing Dyspepsia, is to 
be explained the practice of Mr Halsted, which he 
recommends as a specific in this disease. The plan 
of treatment to which we allude is commenced by 
applying over the anterior part of the abdomen an 
emollient poultice or cloths wrung out of warm 
water, and repeating these until the abdominal 
muscles become perfectly flaccid. The patient being 
placed in such a situation, either standing or sitting, 
as shall most completely relax those muscles, the 
hand of an assistant is to be insinuated deep into the 
soft parts, in such a manner as that ihe bowels shall 
rest in some measure upon the open palm. Then by 
a quick but gentle motion these parts are to be 
pushed upwards towards the stomach, and in this 
manner agitated daily or oftener until an evident 
change for the better is produced, when the fre- 
cuency of its employment is to be gradually dimin- 
ished. 

This is by no means a new plan; it differs but little 
from that recommended and employed by admiral 
Henry in 1787. This latter directs the patient whilst 
in bed, by means of a bone rounded at the end in 
each hand, to knead the bowels as much as possible, 
particularly about the navel, causing, " the two in- 
struments to meet among the bowels as much as 
.hey can be forced to do." 



Dyspepsia, or Indigestion. 189 

From frictions and the warm bath diligently per- 
severed in, all the good effects resulting from the 
practice just described will be obtained, and with 
less trouble to the patient and less danger of doing 
mischief when the stomach or bowels are morbidly 
tender or inflamed. 

3. Mineral Waters. 

The use of the natural mineral waters has been 
recommended in cases of Dyspepsia, and instances 
are related of marvellous cures effected by then, 
agency. The water, impregnated with saline 01 
mineral substances, of many of the natural springs, 
will, no doubt be found of advantage in some of the 
forms of stomachic disease, both inwardly and as a 
bath. But we are persuaded that the good effect 
frequently ascribed to these waters is dependent 
equally upon ihe journey; the agreeable occupation 
of the mind ; the pure air and daily exercise at the 
spring, and the breaking up for a time the ordinary 
bodily and mental occupations— the absence, for a 
season, from the fatigue and anxious cares to which 
the individual had been previously subjected. Je 
the same manner a sea voyage will often effect a 
complete cure. 

4. Tonics and Bitters. 

We forbear to enumerate the numerous tonics — 
mineral and vegetable, the bitters and arcmatics that 
have been at different periods, and are still by many 
writers, recommended for the cure of Dyspepsia. Un 
less aided by the treatment already laid down they 
can do no possible good ; with it they are seldom if ever 
needed. They have in fact produced more injury 
by far than benefit — by being resorted to at an im- 
proper period of the disease, or continued for too long 
a period A light bitter or some simple tonic may, 
'ovvards the termination of the disease, add tone to 



190 Compendium of Domestic Medicine, 

the stomach, but by no means so certainly or effecn* 
ally as will a proper diet, regular exercise, pure air, 
cheerful employments, and the disuse of the vari- 
ous injurious agents usually introduced into the 
stomach. 



CONCLUSION. 

We may remark, in concluding, that the plan of 
treatment we have laid down must be persevered in 
for a considerable length of time before any effectual 
relief is to be expected : stomachic diseases of any 
standing cannot be removed in a few days. It is im- 
portant also that the treatment be uniformly perse- 
vered in, until the cure is eilected and the func- 
tions of the stomach are completely re-established. It 
will not do to adhere to the rules laid down for a 
week or two, and then commit an act of folly or of 
dissipation, returning afterwards in hope of benefit to 
a temporary course of prudence and of temperance. 
Such conduct is more than madness — nothing but 
disappointment can result from it 

Dyspeptics, from the desponding state of mind under 
which they most commonly labour, and an erroneous 
and exaggerated opinion of the nature of their dis- 
ease, of its extent and danger; as well as from their 
want of patience to pursue a long uninterrupted 
series of gentle remedies, and the false estimate very 
generally made by the public of the efficacy of diet 
and regimen unaided by some potent medicine inter- 
nally administered ; render themselves the willing 
dupes of every needy and impudent empiric. Tempo- 
rary relief is often obtained from the pills and panacea 
of the latter ; but the disease, nevertheless, becomes 
more deeply rooted, and the unfortunate patient for 
a moment's ease is made to suffer for life. The dys- 
peptic should always view the empiric as one of his 
greatest enemies — the one most to be dreaded 



SICK-HEADACHE. 



This disease is the result of our advanced state 
of civilization, the increase of wealth and enjoy 
ments in the power of most people in this country, 
and of the luxurious and enervating habits in which 
those in easy circumstances indulge. It is unknown 
among the natives of our forests, or among those of 
the frontier inhabitants whose necessities oblige 
them to live in a manner the reverse of that com- 
mon among the inhabitants of the Atlantic states, 
and particularly the residents of our large cities and 
towns, among whom the complaint very generally 
prevails. Some of their habits are indeed of a na- 
ture directly calculated to lay the foundation of the 
complaint; but the vigour of their constitutions and 
daily exposure to pure air, aided by constant exer- 
cise, are more than sufficient to countervail their 
bad effects. 

The stomach is the seat and throne of this disease, 
and affects the head by means of that sympathetic 
connexion which it holds with it and every organ 
of the human body. High living, over-eating, late 
hours, disposition to acidity in the stomach, partial 
mastication or long continued use of food of difficult 
digestion, suppers, indolence, relaxing habits, and 
the presence of bile in the stomach, are the general 
remote causes. Our remedies therefore must be 

191 



192 Compendium of Domestic Medicine. 

directed to the stomach, and the restoration of its 
nervous functions, the impaired state of which occa- 
sions the agony endured by those who labour under 
the complaint. The desirable change however must 
be efFected by slow degrees; for the stomach gives 
way slowly, and the means of cure must be gradu- 
ally applied. The length of time required to re- 
establish the tone of the nerves of the stomach, will 
vary in different persons in proportion to the violence 
of the disease, the fidelity with which the sufferer 
follows the advice given, and the susceptibility ot 
the stomach to the impression of the remedies, and 
food prescribed : the object of their exhibition how- 
ever will be obtained sooner or later. 



SYMPTOMS. 

An attack of the disease most commonly forms in 
the course of the night, and on awaking, a pain is 
felt in some part of the head, but generally over 
one or both eyes. More or less languor attends it, 
with a diminished or total disrelish for food, and 
great sensibility to light. After continuing for one 
or two days, and even longer, if no remedy be taken, 
a nausea sometimes succeeds, which finally ends in 
vomiting, or this may easily be excited by a draught 
or two of warm water : in either case, relief is soon 
obtained from the more acute symptoms, and sleep 
follows — though a distressing soreness and confusion 
of the head succeed, which gradually go off, and 
health is restored. In some cases the pain in the 
head is preceded by a dulness and heaviness of the 
eyes, and confusion of the brain, which finally ter- 
minate in the fixed pain. Cold feet sometimes pre- 
cede an attack, and constitute the first symptoms of 
its approach. 



Sick-Headache. 193 



MEDICINES. 

In rommencing a regular plan for restoring the 
tone of the nerves of the stomach, a laxative ought 
to be the first remedy; as rhubarb, of which twenty, 
thirty or thirty-five grains, in powder, may be taken 
early in the morning in syrup, or in the form of pills 
of a convenient size made with the same materia]* 
or, which is preferable, with castile soap, on account 
of its purgative power. Its activity may be quick- 
ened, and the object of its exhibition promoted, by 
the addition of one or two grains of aloes, if no 
objection to it exist, arising from its effect on 
the rectum, or from its harsh operation on the 
stomach or bowels. During the operation of the 
medicine, several tea cups of thin gruel made of 
oat meal or corn meal, to which so much salt has 
been added as to be perceptible, should be taken. 
The breakfast after this prescription, and through 
the treatment, may consist of a cup or two of weak 
souchong lea, with a soft boiled egg, weak coffee, 
water in which chocolate nut-shells have been 
boiled, or prepared cocoa, with a slice of dry stale 
bread. The dinner must be of the lightest kind, of 
any of the articles hereafter specified. 

In southern constitutions, an attack of the disease 
is generally brought on by the presence of bile in 
the stomach, the removal of which is therefore indis- 
pensably requisite previous to taking any medicine 
to relieve the headach, or to the commencement of 
any regular system of prevention of the disease. An 
emetic of ipecacuanha, in this case, will be absolutely 
necessary, of which fifteen, twenty, or twenty-five 
grains (according to ease or difficulty of being oper- 
ited on by it) may be taken in half a wine-glass of 
water. Two vegetable anti-bilious pills will insure 
its full operation, and the complete removal of the 
offending cause. The emetic may be worked off 'by 
N 



194 Compendium of Domestic Medicine. 

a tea cup or two of weak chamomile tea, taken at 
intervals, after the medicine has operated two or 
three times. The evening is the most suitable time 
to take the emetic, after the operation of which sound 
and refreshing sleep most commonly follows In 
case the medicine does not operate on the bowels 
once or twice, the dose of rhubarb and aloes be- 
fore mentioned, or twenty or twenty-five grains of 
jalap or rhubarb, with four or five of calomel (if the 
bowels are difficult to move), may be taken the 
following morning or night, and worked off by gruel 
of corn or oatmeal. Nausea from the calomel is in 
general prevented by the addition of a few drops of 
essence of peppermint, or a tea-spoonful of compound 
spirit of lavender. If it come on, it may be relieved 
by a few spoonsful of a watery infusion of cinnamoi 
or ginger, or by a little mint water. No fear neer 
be entertained of the proportion of calomel prescribes 
affecting the mouth (unless the system be uncom- 
monly sensible to its effects), for the quantity added 
to the jalap and rhubarb insures its passage through 
the stomach and bowels — whereas a smaller dose 
might not be removed, and would then touch the 
mouth ; at the worst its effects will only be temporary. 
This important preliminary being settled, the pa- 
tient must commence with the following medicine 
Prepared rust of iron, 1 drachm (60 grains), 
Columbo root, fresh powdered, 2 drachms, 
Orange peel, 3 drachms. 
Mix and divide into twenty papers: one to be taken 
morning and evening, in a small quantity of jelly or 
syrup, and washed down with a wine-glassful of 
cold water. 

After taking the above medicine for four weeks, 
rhubarb, recently powdered, may be substituted for 
the columbo, and if it be desired to render it more 
grateful, cinnamon may be added to the whole. If 
the dose be inconveniently large, the number of 
papers may be increased to thirty. After another 
month's use of this new prescription, the bitters may 



Sick-Headache. 195 

oe omitted for four or five weeks, and the prepared 
rust of iron used alone. 

The occasional presence of bile or acid in the 
stomach, an occurrence that is easily known by the 
invalid, must be removed, by some anti-bilious 
pills for the bile : and for the acid, by twenty 
or thirty grains of magnesia, or dried subcarbonate 
of soda in the dose of from ten to twenty grains, in 
pills made with castile soap, three or fbur of which 
may be taken in a day. 

We have known Fowler's mineral solution given 
with great benefit in this disease : and our confidence 
in its powers, induces us to recommend it in violent 
cases. When taking it, the patient is not to drink 
cold water, or take cold. 

The dose may be from three to five or ten 
drops at the utmost, in half a wine glass of water, 
early in the morning, for an adult. If nausea be 
produced, it may be taken when going to bed, or 
me or two hours after a meal. The addition of a 
tea-spoonful of compound spirits of lavender (where 
this medicine has not previously been added) renders 
't more agreeable, and prevents nausea. It must be 
discontinued, for a short time, when swelling in the 
face, or a sense of fulness in the eyes, is perceived. 
After the return of a fit, it may be again commenced. 
If nausea, or griping follow its use, the dose must be 
lessened. 

A tea-spoonful of common salt, dissolved in half a 
pint of water, and taken frequently in the course of 
the day, has afforded temporary benefit in a feu 
cases; but we do not recommend it, by reason ol 
its uncertainty. 

The use of cider, as a remedy in this disease, was 
long since highly extolled by Dr N. Dwight of Con- 
necticut: but we are convinced that the relief ob- 
tained by it mast be only temporary; and we have 
known many, too many instances of ruinous attach 
ment to strong drink, from early morning doses of 
tincture of Peruvian bark, and the infusion of other 



196 Compendium of Domestic Medicine. 

vegetable tonics in Port wine, to prevent or cure 
fever and ague, dyspepsia, or complaints called ner- 
vous, to permit us to sanction the use of even cider 
for Sick-headach. 



DIET. 

As bread constitutes so large a portion of our 
daily aliment, and forms a most important item in 
the articles by which a cure of this distressing com 
plaint is to be effected, it demands the first notice. 

Bread should be light, and none other must be 
touched. There is no excuse admissible for heavy 
bread. If corn bread be used, it should be eaten in 
the form of thin, crisp cakes. I cannot conceive a 
more injurious article of diet, to a wejak stomach, 
than the hot corn bread of the southern slates. No 
wheaten bread should be eaten, unless twenty-four 
hours old. Economy and health unite in proscribing 
fresh bread as an article of diet: for, however palat- 
able, it is highly injurious to the stomach, and tries 
its powers more than almost any other of the causes 
of disease. During the years of youth, when the 
natural vigour is daily deriving an accession of 
strength, — or, in constitutions enjoying greater pow- 
ers of the stomach than are absolutely required for 
the purposes of digestion, fresh bread may be eaten 
with impunity for years ; but I will venture to assert, 
that every meal in which it is taken, will detract 
some little from the powers of that organ, and that, 
in time, it will show its effects. As an attachment 
and -relish for bread one day old is acquired in a 
short time, the sooner the former is left off the bet- 
ter; indeed a care must not be expected, so long as the 
use of fresh bread is indulged in. 

In cases of severe affliction from the disease, and 
where a disposition to acidity prevails in the stomach, 
tt is advisable to lay aside raised bread altogether, 
and to sr bstitute shipbread or crackers, or rice boiled 



Sick-Headache. 197 

dry. Where the teeth have failed, biscuits may be 
soaked in cold water, a short time before they are 
wanted. Bread made from unbolted wheaten flour, 
commonly called bran bread, is to be preferred to 
white bread. 

That species of animal food which has been found 
to agree best with the invalid should be eaten, and 
none else. Wild meats, being more tender, and 
more easily digested than the flesh of domestic ani- 
mals must be taken advantage of whenever occasion 
will permit. Our markets annually furnish, in the 
proper seasons, abundance of venison, which, of all 
our meats, is the most proper for those afflicted with 
a weak stomach, or Sick-headach. Game of all kinds, 
and rabbits, afford an ample variety of tender food. 
Beef is an article upon which we can sirbsist longer 
without disrelish, than almost any other. The part 
of the sirloin, containing the tenderloin, should be 
preferred ; though other parts, provided they are 
tender and juicy, may be eaten. Good mutton may 
be a standing dish. If either be roasted, ihe over 
done outside parts are to be avoided, being difficult 
of digestion. Beeves' tongues, salted and smoked 
and corned beef, are equally proper, and even medi- 
cinal, owing to the stimulus of the salt used to cure 
them. In general, corned beef is not half boiled by 
American cooks. Slow, steady boiling, for several 
hours, is requisite, to render that article sufficiently 
tender for a deranged stomach. Rapid boiling occa- 
sions a waste of fuel, dissipates with the steam the 
volatile and savoury particles of the meat, and thus 
-enders the article less good and palatable The 
water in which meat is boiled, should be kept just at 
.he ooiling point. The same rule holds in regard to 
soup 

The lean part of a white fat fillet of veal may be 
occasionally eaten. The knuckle of veal must never 
De touched, being very difficult of digestion. 

Of shell-fish, crabs and oysters are the only spe 
cies allowable. The latter should always be accom 



198 Compendium of Domestic Medicine, 

panied with a due proportion of bread or biscuit, to 
compel mastication, and prevent over-eating. Lob- 
sters are inadmissible. 

There can be no objection to trout, rock (streaked 
bass), black-fish, sea-bass, sheepshead, perch, flound- 
ers, and whiting. Boiled fish are generally found 
more easy of digestion, than when otherwise pre- 
pared. The use of other fish must be regulated by 
the effects produced on the individual eating them. 

Soft boiled eggs, poultry, and ham well boiled, 
may properly constitute a part of the dinner of an 
invalid. Pork, unless young, and fed on corn and 
milk, is too strong; and in any case, the lean part 
only should be eaten Meat pies are ruinous to the 
stomach of all subject to Sick-r.eadach. 

But whatever may be the article of animal food 
that constitutes the material of dinner, the following 
rules ought to be constantly observed : 

1. If the meat be not salted, it should be kept as 
long as possible before it is cooked, that it may be 
tender. 

2. Whether roasted, boiled or stewed, meat ought 
to be done until tender. French cooks pay much 
more attention to this point than those of America or 
England. 

3. Simplicity in diet is essential to those subject 
to Sick-headach. The weak stomach revolts at the 
task of overcoming the difficulty of digesting a din- 
ner composed of numerous ingredients, and eilner 
rejects them, or labours to do the hard duty thus 
imposed. It may succeed, after a time, though 
every such exertion tends infallibly to increase the 
disease in question. 

The dinner ought to consist of one dish of animal 
food, and one or two of vegetables, besides bread ; 
for the stomach is less strained to extraordinary activ- 
ity, than when several different articles are eaten. 
Besides, some articles, apparently of the same nature, 
do not agree when mixed, and may do harm by creat- 
ing a disturbance in the stomach, the quiet of which 



Sick- Headache. 199 

it is important to preserve. The principle of this 
harmony of aliments applies almost with equal force 
to vegetables, among which we see agreements and 
disagreements, almost as great as those we remark 
in the mixture of two articles of animal food, or of 
fish and flesh. There are few articles upon which 
we can live so long without tiring, as beef, potatoes, 
and rice. These are so innocent, and so well adapt- 
ed to give tone to the stomach, that they ought tc 
constitute the diet of such as are labouring under a 
Sick-headach, as long as they can be procured, or 
taken without disrelish. Much of their excellence, 
nowever, depends upon their cooking. It is essen- 
tial that the potatoes be mealy, and that the rice be 
boiled dry : as this article agrees with most persons, 
every invalid is urged to use it as steadily as possi- 
ble. Green peas, carrots, parsnips, and small homi- 
ny, may occasionally be substituted. 

4. Slow and complete mastication of food is indis- 
pensable. The pleasure, moreover, of eating, is 
very much increased thereby ; because the organs 
of taste are more forcibly impressed than when the 
food is a shorter time retained on them, by imperfect 
mastication. Another advantage of slow eating is, 
*4iat, the stomach being gradually distended, there 
is less danger of its being overloaded, and it is less 
sensibly affected by the subsequent relaxation, than 
if the food be hastily swallowed. When slowly and 
fully comminuted, the food is also more equally ex- 
posed to the action of the saliva and gastric liquor, 
which are designed by nature to dissolve it The 
digestion of food is thus promoted. Long intervals 
between meals render the adoption of this practice 
very difficult; for the keenness of the sensation of 
hunger involuntarily forces us to eat quickly. The 
invalid should, therefore, never permit that sensation 
to proceed further than to cause a relish for food 
which should consequently be taken as often as is 
requisite, without reference to the regular hours of 
the family meals. Various articles can always be at 



200 Compendium of Domestic Medicine, 

hand. But, on the contrary, unappensed hunger is 
not less injurious, than adding to the load in the 
stomach before the previous meal has been digested. 
The inevitable consequence of this repletion is, that 
digestion is disturbed, the organ is unduly roused to 
overaction, and, in the end, evinces the loss of vigour, 
by the occasional derangement of its nerves, and the 
production of the distressing sympathetic affection of 
the pain of the head. The effects of such indiscretion 
are often shown several days after it has been com- 
mitted ; but most commonly the next day. 

5. Moderation in diet must always be attended 
to. The stomach may be injured, by being over- 
loaded with simple food, as certainly, though not so 
speedily, as by other food of improper quality. The 
invalid should leave off eating, the moment the first 
distention of the stomach is perceived. Slow masti- 
cation favours satiety, without inducing undue dis- 
tention. The dinner should consist principally of 
vegetables. Most persons in the United States eat 
much more animal food than is necessary for or con- 
sistent wilh health. 

The rule with respect to butter shall be short. A 
more innocent article of food is not to be found than 
pure fresh butter, nor a more injurious one than 
strong butter The former may, therefore, be safely 
taken in moderation, provided it be found not to dis- 
agree with the stomach. This point can easily be 
settled by the invalid. Many physicians, without 
consistency or reflection, cry out against fresh butter 
as noxious, and yet will prescribe repeated doses of 
castor-oil, without once inquiring whether it is not, 
as it often is, offensive from rancidity. The most 
innocent mode of using butter is to spread it cold on 
bread twelve hours old, or on biscuit previously 
soaked. 

Soups of every kind are highly injurious to those 
troubled with Sick-headach, and ought therefore to 
be avoided. They suddenly distend the stomach 
without giving tone, and, in the way usually made 




DARTTLAGES OF LARYNX AND EPIGLOTTIS, AND 
UPPER RINGS OF TRACHEA, SEEN FROM BEHIND. 

(Taken from Todd and Bowman.) 

a, arytenoid cartilages, b, superior cornua of thyroid 
cartilage, c, its inferior cornua. d, posterior surface 
of cricoid. /, epiglottis, with its perforations, h. its 
left inferior tubercle. *", upper margin of thyroid, t, 
trachea. 



Sick- Headache. 201 

are injurious, from the grease they contain and 
which, from the heat they are subjected to, are much 
disposed to create acidity. 

The best gravy of all roasted meat is its own 
liquor. An invalid's stomach is better without any. 
The ranced fried liquid fat, passing under the name 
of gravy, is ruinous to the stomach of those subject 
to Sick-headach. Vinegar pickles must be shunned. 
They are injurious from the indigestible nature of 
the solid article, and from the acid used in their pre- 
servation. But mustard and horseradish may be 
safely eaten ; they are gently stimulating ; and in an 
habitual colic, arising from gout, the latter has been 
eaten at all hours, with the most marked benefit. 

Vegetable acids of all kinds, and fruits, are highly 
injurious. Some of the latter may be more particu- 
larly hurtful, on account of the difficult digestion of 
their skins. Cherries in one case, and apples in 
another, excited severe attacks of the disease. 

It will be observed that we have said nothing 
about desserts. We proscribe them all. There can, 
indeed, be no objection to plain puddings made of 
rice, bread, biscuit or potatoes, provided the butter 
in them is not found to disagree with the stomach, 
and provided they are eaten sparingly, and after a 
moderate dinner. Calves-feet jelly, without wine, 
is equally innocent, and may be taken to the extent 
of a glass with safety. A plain apple pie, with well 
baked and very light crust, may also be occasionally 
eaten, with the same caution as to quantity: but we 
hold up both hands against rich pastry, and a variety 
of rich puddings w 7 hich the ingenuity of cooks have 
invented to please the palate at the expense of health. 
They are death to a stomach subject to the derange- 
ment of nerves producing Sick-headach. The invalid 
is better without any dessert ; for granting that the 
articles are in themselves innocent, yet they may be 
injurious by their bulk, and by disagreeing with 
those constituting the substantial part of the dinner. 
Besides 'he stomach acts with most vigour wnen 



202 Compendium of Domestic Medicine. 

employed in digesting the fewest articles; and, 
therefore, it is wrong to try its powers by undue ex- 
ertion, or even to risk its derangement by a mixture 
of food. If any argument be necessary to urge the 
adoption of this simple diet, and to reconcile those 
subject to Sick-headach or dyspepsia, to the depri- 
vation of their usual supposed comforts, let it be re- 
membered, that the more steadily they submit to the 
discipline recommended, the sooner the object of it 
will be attained. Let them also reflect, that in ex- 
changing temporary sensual gratification, and conse- 
quent suffering, for the habits and food that will, in 
a short time, prove as agreeable as those they have 
relinquished, they will also acquire light pleasant 
feelings, elasticity and serenity of mind, and all those 
sensations arising from the permanent enjoyment of 
good health, and freedom from pain; and above all, 
for uninterrupted capacity to discharge the duties 
which their various situations in life may demand 
They must, however, bear in mind that a return to 
old practices will unquestionably, sooner or later 
cause a return of their complaints. We can assure 
.hem, however, that they will, in a short time, become 
reconciled to the rational mode of life recommended, 
and that they will not only afterwards pursue it from 
choice, but advise others to adopt it. 

Tea and coffee must be taken in great moderation. 
In place of them, for breakfast, the articles noted in 
page 193, or a small portion of some of the varieties 
of animal food mentioned at page 197, may be sub- 
stituted ; with ihe addition of sound bottled claret, 
if the acid of this wine should be found not to disa- 
gree with the stomach. The claret must be diluted 
with water. In the evening a cup of souchong may 
be taken with safety ; but it would be better to omit 
it, and to take a few oysters, or a soft boiled egg or 
two, an hour at least before bed time. Regular sup- 
pers must be wholly laid aside. 

Invalids should avoid dinner and supper parties. 
<or they thereby escape the inducement to transgress 



Sick- Headache. 203 

the rules prescribed for their cure, the importunities 
and remarks upon their forbearance from the thought- 
less and inconsiderate, and the reflections which may 
prove mortifying to them from seeing others, either 
in high health, or who set bad health at defiance, 
eating freely of what they call the good things be- 
fore them 



DRINKS. 

Let every one afflicted with the Sick-headach be 
assured of the fact, of the superiority of water as a 
diluent, and throw aside wine, spirit, and malt liquors. 
In the winter, if the coldness of the water should 
prove disagreeable, or give pain when taken, these 
effects may be prevented by pouring boiling water 
on toasted bread or biscuit, and permitting the tem- 
perature of the water to descend to a degree that 
may be found pleasant. It may then be taken at 
meals, or at any other time in the course of the day 
when required. This toast infusion is far preferable, 
and more palatable, than that made by infusing a 
hot toast in cold water. Those who are not blessed 
with water naturally pure, should, if possible, use 
distilled water; the benefit of which the late and 
experienced Dr Heberden, of London, thought might 
be as great in many chronic complaints of the sto- 
mach and bowels, as the most famous mineral waters 
are in other disorders. Dr Lamb says he was cured 
of a Sick-headach by the use of distilled water, and 
that he was informed of the same complaint having 
been relieved in others by using it. particularly by a 
gentleman more than sixty years of age. The same 
author relates several cases of the decided good 
effects of distilled water in various chronic com- 
plaints, as cancer, gout, obstinate cutaneous erup- 
tions, <fcc. Dr Adair also adds several facts of its me- 
dicinal powers. If distilled water be used, the first 
gallon that comes over should be thrown away F<»» 



204 Compendium of Domestic Medicine. 

want of it, the water may be boiled ; and, in both 
cases, it should be put into an upright churn, with- 
out a cover, and agitated for some rime, to impreg- 
nate it with the air which it loses by either operation 
and, for want of which, it has a vapid and peculiar 
taste. In places where the water is obviously im- 
pure, or bad tasted, it ought to be passed through a 
filtering stone, or, which is better, a filtering appara- 
tus The water drinker will find, after a short trial, 
that he will never want the luxury of an appetite ; 
that the sensibility of the organs of taste is increased, 
and that he will thereby add to the pleasure of eating. 

But it must be remembered, that a cardinal point 
in the cure of all diseases of debility in the stomach, 
or of derangements in its functions, is to take no more 
drink at meals than is sufficient to promote the solu- 
tion of the food in its natural solvents, and its passage 
out of the stomach. Haifa pint, or a little more, is 
enough. 

The operation of the good effects of the tender 
modes of cooking, in France, is prevented by the 
large draughts taken by the people of that country 
at dinner: and indigestion is known to be a prevail- 
ing disease among them. During the day thirst must 
be assuaged, either by plain water, or water impreg- 
nated with carbonic acid, the method of doing which 
is now generally known. Where aciditjr prevails in 
the stomach, ten or fifteen grains of the supercar- 
bonates of soda or of potash, should be added to each 
glass without syrup. Half a tumbler is enough 
for one draught. More would cause uneasy disten- 
tion of the stomach. This drink, taken daily, has, 
in one case, suspended a severe Sick-headach for 
several months. The alkali may be dissolved in a 
wine-glass of milk, and pure water taken after it, if 
aerated water cannot be procured. 

The tonic effects of malt liquors on the human 
body, when not contra-indicated by some circum- 
stance, would naturally lead those not acquainted 
with them, to expect that they would be highly be 



Sick-Headache. 205 

neficial i-n the present complaint: but they are inju- 
rious, from containing more or less free acid, and 
must, therefore, be avoided. 

Attention to the state of the bowels is of essential 
importance in this disease. Costiveness not only dis- 
poses to its origination, but increases the disposition 
to frequent attacks of it. The bowels must, there- 
fore, be constantly kept open by the use of occasional 
doses of medicine, when necessity may require it. 
The Congress Spring water, at Saratoga, is the best 
laxative for the purpose; for it is the peculiar pro- 
perty of this admirable water not to weaken like 
other purgatives. Three tumblers full, taken early 
in the morning, are enough at a time. When drank 
on the spot, a tumbler of the Flatrock water, which 
is a pure chalybeate, may be taken in the afternoon. 
Where the Congress water cannot be procured, rhu- 
barb may be substituted, and, to prevent it giving 
pain, three or four drops of the essence of pepper- 
mint may be added to the dose ; or about thirty grains 
of the root may be cut up and chewed; the effects, 
when thus used, will be more slow and natural than 
when a full dose in powder is taken. If there be an 
aversion to this excellent medicine, castor-oil may 
be substituted. Spinage, when in season, simply 
prepared, and slightly seasoned, should be eaten at 
dinner, when constipation comes on. Where acidity 
prevails in the stomach, half a drachm to a drachm 
of calcined magnesia should be taken in milk. 

It would certainly conduce to the promotion cf the 
vigour of the body, or, at least, prevent the increase 
of muscular relaxation, if enervating feather beds 
were laid aside, and mattrasses of hair, or southern 
moss, substituted. In summer, a feather bed is an 
absurdity. Even in winter, a short time will recon- 
cile the most delicate to mattrasses, when they will 
invariably be preferred to feather beds. In cold 
weather, a blanket may be put between the sheet 
and the mattrass. 



206 Compendium of Domestic Medicine. 



EXERCISE. 

Exercise is an essential remedy in the cure of the 
Sick-headach. But under the word exercise, so much 
is comprehended, that it is necessary to enter into 
detail respecting it. No species of bodily motion, no 
variety of the species of exercise commonly used, will 
have the desired effect, unless under proper regula- 
tions, and in conjunction with a due observance of 
the whole system of conduct laid down in the pre- 
sent set of directions. It is only one of the means 
prescribed, and may be defeated by, or even interfere 
with the rest that are essential, by being improperly 
used, or by inattention to other directions. The ex- 
ercise must be in the open air, and occasionally be- 
fore breakfast. If taken in the house, it fatigues 
without effecting any change in the system. Riding 
on horseback, on account of the agitation of the in- 
ternal viscera, is, of all species of exercise, the most 
proper; and should be constantly taken, every morn- 
ing, when the weather will permit, A long journey 
is much preferable to daily short rides at home, on 
account of the exhilarating and medicinal effects of 
the continued change of scene and of air on the 
system. Occasional stops should be made, and exer- 
cise on foot taken. Exercise, however, alone, will 
not cure or prevent the disease, which is known to 
affect persons of the most active dispositions, and 
possessing considerable muscular vigour. 

If it be not convenient to take a long journey, 
daily rides at home, or walking exercise, may be 
substituted. Some business, or object of investiga- 
tion, ought always to be had in view when exercise 
is taken, as a visit to a friend, the local topography 
or geology, mineralogy or botany of the country, &c. 
&c. To this must be added gentle frictions from 
right to left, on the side, and region of the stomach 
and bowels, with the flesh-brush or flannel, for fifteen 



Sick-Headache. 20? 

minutes, every morning before rising, and after meals 
The benefit of this remedy, though slow, is certain 



CHANGE OF AIR. 

A powerful remedy, in the cure of this disease, 
is a change of air. The influence of the air of a 
plare, in the production of diseases, is evident from 
a variety of facts; and the prevention and cure 
of them obtained by a temporary change of air, or 
permanent removal of residence, is no less indis- 
putable. 

A striking effect of the change of air in the Sick- 
headach, occurred in a citizen of Philadelphia, who, 
from his sixteenth year, had been subject thereto, 
and in whom, until he had passed his fortieth year, 
it annually increased in force and frequency, so as to 
render his life miserable. A few years since he re- 
moved from the small and confined house, in which 
he had lived for many years, to one of larger size, 
having a spacious garden; and the consequence was, 
that, in the course of two years his headach became 
much less frequent, and his general health improved. 



OTHER CAUTIONS. 

Diseased teeth frequently excite this disease. In 
the commencement of a cure, therefore, all stumps 
that give occasional pain, and all hollow teeth not to 
be rendered useful by plugging, should be extracted 
Slight decays in other teeth must be cut out, and the 
cavities plugged. 

Early hours are essential to the cure of the com- 
plaint. This refers to bed-time and rising, and the 
invalid should make it a point never to indulge in 
the unsound sleep that is apt to follow lying in bed 
in the morning, after being awake some time. The 
Janguor induced by a long continued recumbent pos 



208 Compendium of Domestic Medicine. 

hire of the body, promotes that torpor of the diges- 
tive organs which contributes to the origination of thp 
disease, and its continuance. A headach almost in- 
variably ensues from such practice, with the loss of 
that refreshing sensation arising from the sound re- 
pose of the preceding night. 

Cold feet frequently excite the disease. Care must 
be taken, therefore, to guard the feet from cold 
and wet, by cork-soled or Indian rubber overshoes, 
w T hich are now made with great neatness, and by 
wearing warm stockings. Flannel socks should also 
be worn in winter when going to bed, and may be 
pulled off in the course of the night, when the warmth 
of the body has become equally diffused. 

No one subject to Sick-headach should sleep with 
a fire in the chamber; for the diminution of tempe- 
rature that often takes place in the course of the 
night, from the fire going out, or from a change in 
the weather, disposes the system to catarrh, and 
every such indisposition retards the cure of the dis- 
ease. This remark does not apply to Canada, or the 
eastern states, where the severity of the cold renders 
the preservation of an uniform temperature in the 
whole house, during winter, an object of unceasing 
attention; nor to those who have the means of keep- 
ing up a regular heat in their chambers during the 
night. The thermometer should not be permitted to 
rise above sixty degrees. The proper practice is, to 
have a fire kindled, early in the morning, in a sheet- 
iron stove, which heats quickly, or to dress in an 
adjoining room, where there is a fire. Bed-curtains 
should not be used. 

If the system feel exhausted by the duties of the 
morning, and require repose after dinner, to recover 
its energies, sleep for half an hour may be indulged 
in, to great advantage, with the bodv in an erect 



Sick- Headache. 209 

position, or nearly so. A recumbent posture should 
never be adopted, if a cure be hoped for. The prac- 
tice, while in perfect health, of regularly going to 
bed after dinner, for an hour or more, is productive 
of the most enervating effects, and should never be 
adopted, by young persons who are desirous to pre 
serve or acquire firm muscles, good complexions, or 
strong nerves. 

No one who values the preservation of a vigorous 
state of the surface, or wishes to prevent the gradual 
diminution of its tone, should ever permit a warming 
pan to-enter the bed. In cases of natural delicacy 
of constitution, a flannel gown may be used to sleep 
in. One of the surest methods to invigorate the skin, 
and to prevent a disposition to take cold, is to rub 
some part of the body every morning, on rising, with 
a coarse tow T el dipped in cold water. The refreshing 
sensation arising from this practice is so great, that 
no one who tries it will deprive himself of the grati- 
fication. The well known sympathy between the 
surface and the stomach, authorises a belief that the 
practice would prove a powerful auxiliary to the 
system recommended for the cure of the sick- 
headach. 

The passions of the mind must be kept under with 
especial care. Every mental irritation will add 
strength to the disease, and retard the wholesome 
operation of the remedies prescribed for its cure. 
The common effect of giving way to fretting, peevish- 
ness, or resentment, is an attack of the complaint 
A determination should be made to overcome this 
disposition. One effect of the system of diet recom- 
mended for the cure of the complaint, is a happy re- 
volution in the temper, from great irritability to phi- 
losophic endurance of the little evils of life, and the 
power of self-command. The mind and the corpo- 
real functions are intimately connected and mutually 
act and react on each other. Every source of do* 
mestic irritation should, if possible, be avoided. The 
troubles of life affect the digestive organs very sen 
O 



210 Compendium of Domestic Medicine. 

stbly, and operate with increased force when they 
are joined to improper food, or other remote causes 
of the disease. 



TREATMENT OF AN ATTACK OF THE 
COMPLAINT. 

If the disease announce its approach, which it 
sometimes does, by certain premonitory signs, as 
heaviness of the eyes, or confusion of the head, no 
time ought to be lost in arresting its progress. If 
the prevalence of an acid or of bile in the stomach 
be known, attention must be paid to their removal. 
If the first be present, twenty or thirty grains of 
calcined magnesia, or ten or fifteen grains of super- 
carbonate of soda or of potash, may be taken in 
a tumbler of artificial mineral water; and if this 
cannot be procured, they may be mixed with new 
milk or gum-arabic water: to both, the addition of 
orgeat, syrup of sugar, or of ginger, all render the 
draught more agreeable, 

Bile is to be removed by a brisk purge of com- 
pound podophyllin pills ; after which, if relief be 
not obtained, fifteen, twenty, or thirty drops of 
laudanum may be taken in half a wine-glassful of 
water, with the addition of a tea-spoonful of com- 
pound spirit of lavender, and sleep encouraged by 
retiring to bed in a dark room. If, on awaking, the 
pain in the head should not have disappeared, its 
removal will be promoted by the person remaining 
in bed, and repeating the dose. It is better, how* 
ever, to take enough at first, to insure a sound sleep 
for several hours; after which it commonly happens 
that no symptom of the disease remains, except a 
slight confusion of the head, arising from the effects 
of the laudanum: but this will disappear in a short 
time, by taking a cup of clear strong coffee, without 
sugar or cream. 

In this way relief from the present symptoms will 



Sick-Headache. 211 

oe certain ; and by repeating the foregoing process 
a few times when the attack returns, it will be 
shortened, and the habit of the disease be broken 
and by due care to avoid the causes that excite it 
and the use of the medicines, diet and regimen re- 
commended, its return may be prevented. 



212 Compendium of Domestic Medicine. 



THE TEETH. 



It is intended in the following treatise, 

1. To give, in as few words as possible, a clear 
description of the structure and formation of the 
Teeth; and to bring to view those circumstances con- 
nected with their growth, with which it is important 
for every individual to be acquainted. 

2. To give a brief sketch of the most common dis- 
eases to which the Teeth are liable; together with 
such directions, relative to their treatment and pre- 
servation, as shall enable the reader to take the 
necessary care of his own Teeth; and, if a parent, to 
pay proper attention to the Teeth of his children. 
The reader is aware that the diseases of children are 
not embraced in the plan of this Compendium of Do- 
mestic Medicine ; but the author, in treating of 
the Teeth, has found it impossible to avoid some 
notice of the subject — unless at the hazard of omit- 
ting much that is interesting and instructive to those 
to whom this work is professedly addressed. 

3. To guard against the injurious practice of igno- 
rant operators ; and to remove some of those popular 
prejudices which prevent many from adopting the 
only treatment calculated to diminish the liability 
to disease in these useful and important organs. 




A, the separate human teeth as they occur in the half 
jaw of the adult. B, the human teeth in situ in the 
upper jaw. a, a, incisors. 6,6, canine, c, c, premolars. 
d, rf, true molars. 



The Teeth. 213 



STRUCTURE, NUMBER, FORM AND ARTICULA- 
TION OF THE TEETH. 

In order to render the description of the Teeth, and 
of their diseases, as clear and comprehensive as poss- 
ible, anatomists have considered a Tooth as divided 
into three parts or sections ; first, the body or crown ; 
second, the neck : and third, the root or fang. 

The whole of that part o£*a Tooth which is gene- 
rally exposed to view, when the gums are in a 
healthy state, is called the crown. The part which 
is immediately embraced by the gums, and to which 
they are united, is called the neck. The third section, 
or fang, is all that part which is found buried in the 
socket, when the bony process, of which the socket 
is formed, is in a perfect state. 

The hard or bony structure of the Teeth is described 
as consisting of two substances; one of a dense bony 
nature, much harder than that of any of the other 
bones, and of which are formed all the internal parts 
of the crowns, the w-hole of the necks, and also the 
fangs of the Teeth. The enamel, or external cover- 
ing, is the other hard substance, which, however, 
forms only a part of the crown. It is of a peculiar 
nature, possessing a hardness and density exceeding 
that of any other substance in the whole body, and 
covers the crowns of all the teeth, but is seldom in 
any part more than a line in thickness. It is thickest, 
at those parts w hich are most exposed to use ; and 
thinnest, at those nearest the gums. 

The Teeth, like the other bones, are hollow, having 
a cavity in their crowns, corresponding, in form, to 
the external part of the tooth, and a canal in each fang, 
extending from this cavity, and terminating by a 
small opening in the point of the fang. These cavi- 
ties, however, are not, as is commonly supposed, for 
the lodgement of marrow, as in the other bones, but 
to srive plare to blood vessels a \d nerves, on which 



214 Compendium of Domestic Medicine. 

the Teeth depend for their nourishment and sensi 
bility. 

The dimensions of these cavities are found to vary 
according to the degree of perfection attained in the 
formation of the Teeth ; being greatest in those which 
are very young, and becoming gradually smaller, 
till their formation is completed. In the Teeth of 
adults, they become still less, as the individual ad- 
vances in years, so that in those of very aged persons 
these natural cavities are often found to be entirely 
closed, or filled by solid bone. 

Of the two sets of Teeth with which the human 
jaws are successively furnished, the first are called 
the temporary, infant, or Milk-Teeth ; and the second, 
the permanent or adult Teeth. There is most com- 
monly a difference in the number which composes 
these two sets, the first containing twenty, and the 
second thirty-two. The number in the second set is 
often found to vary, being in some greater, and in 
others less : but this variation seldom occurs in the 
first set. 

Both sets are divided into classes. In the first set 
there are, in each jaw, 

1. Four front Teeth (Incisores), two on each side. 

2. Two eye Teeth, or canine Teeth {Cuspidati), one 
on each side. 

3. Four grinders, or double Teeth (Molares), two on 
each side. 

The front, and canine Teeth are succeeded, in the 

permanent set, by Teeth of the same denomination; 

but the grinders of the first set are followed in the 

second, by- 
Four double-pointed Teeth, or small grinders (Bi* 

cuspides). 
In addition to which there are m this set, a fourth 

class, viz. 
Six large grinders, or double Teeth (Molares), three 

on each side ; the last of which, on each side, is called 

wisdom-tooth. 
The Teoth of both sets, or those of the same class 



The Teeth. 235 



ill both, bear a strong resemblance to each other; so 
that, in many instances, at the period of shedding, 
the teeth of one set have been mistaken and extracted 
">r those of the other. 

The roots of all the front and canine teeth, in both 
Bets, are single, and generally straight and tapering ; 
and those in the upper jaw are commonly the longest 
The fangs of the small grinders (bicuspides) are 
flatted and thin, often a little crooked and tapering, 
and generally some of them forked at their extremi- 
ties. All the double Teeth (molares) in both sets 
have, in the under jaw, two fangs, and in the upper 
one, three ; two of these being fixed towards the outer 
edge of the jaw, and the other towards the roof of 
the mouth or palate. In many instances, however, 
the grinders of the upper jaw have four, or even five, 
fangs ; and those of the under jaw, three. And on 
the contrary, some of these Teeth, which are gene- 
rally designed by nature to have two or three fangs, 
are found with but one. 

The Teeth are connected with the jaws by the 
means of sockets, which are formed to receive and 
fit each particular fang, and by intermediate mem- 
branes, which serve at once for linings to the sockets, 
and coverings to the fangs ; so that the roots of the 
Teeth are not immediately articulated or joined to 
the bony sockets, but are united by these membranes. 

The sockets which receive the Teeth are formed 
of thin plates or processes of soft spongy bone, which, 
while they embrace the fangs of the Teeth, serve as 
a support to the gums. These plates of bone, which 
are called alveolar processes, are produced, and in- 
creased, with the formation and advancement of the 
Teeth; and there is such a mutual dependence of the 
teeth and these processes on each other, that a Tooth 
is no sooner removed, than a wasting of the process 
commences, and all traces of a socket soon disappear. 
And on the contrary, when this dissolution and ab- 
sorption of the processes are first effected, as is often 
the case in consequence of disease, the Teeth imme 



216 Compendium of Domestic Medicine. 

diately become loose and painful, and the patient is 
almost constantly afflicted till they are wholly re- 
moved. Thus it appears, that where there are no 
Teeth, there can be no alveolar processes, and where 
the alveolar processes are destroyed, the Teeth can 
no longer be preserved. 

These bony sides of the sockets are covered, like 
the rest of the jaw, by a thick strong membrane, 
called periosteum, whicn contributes greatly to su pport 
and strengthen them. The gums are next spread 
over this periosteal covering; and these again are in- 
vested by a very delicate membrane, which is con- 
tinued over the lips, tongue and throat, and is indeea 
the immediate lining of the mouth. All these soft 
parts, which cover the sockets of the Teeth, are so 
intimately united by the intermixture of their fibres 
and vessels, that they cannot be distinctly separated 
by the knife, and appear, on dissection, like one uni- 
form and homogeneous substance. 

These parts, and the membranes which connect 
the teeth with their sockets, serve for the transmission 
of innumerable small vessels, which go to nourish 
the jaws and teeth. Vessels and nerves of conside- 
rable size enter the jaws, and pass in channels at the 
deepest part of the sockets, where they supply the 
fangs of all the teeth with small branches ; and in 
this way the cavities of the teeth are furnished with 
arteries, veins, and nerves, that enter at the fangs 
by the small openings in them, which have been men- 
tioned above. 

In order to illustrate the descriptions which have 
been or may be given, the following print has been 
drawn and engraved. It consists of a representation 
of the bones of the face, in which the first and second 
sets of teeth are so exposed as to show their relative 
situation in both jaws, as found in a child of six or 
<seven years of age. 

Tne preparation from which the drawing was 
taken had all the flesh removed, and the outer plate 
**" *he alveolar processes sawed and cut away in 



The Teeth. 



iuch a manner as to bring to view the fangs bf &e 
temporary teeth, and the crowns of the perma* *nt 
set which were beneath them. 




Explanation. 

a. a. a. Three front Teeth of the first set, the 
other had been shed. 

b b. The canine or eye Teeth of the first set 

c. c. c. c. The double Teeth or grinders of the first 
set, their fangs being partly absorbed. 

1. 1. 1. 1. The crowns of the front Teeth of the 
permanent set, one of which, in the under jaw, is 
fully advanced, and is in the place of a temporary 
tooth whifh has been shed. 



218 Compendium of Domestic Medicine, 

2. 2. The crowns of the permanent, canine or eye 
Teeth. 

3. 3. 3. 3. The crowns of the double-pointed Teeta 
or small grinders of the permanent set. 

4. 4. The first large grinder or douhe tooth of thf 
permanent set in each jaw, the fangs of which ar\ 
not fully formed. It is owing to the early appea 
ance of these Teeth beyond the temporary grinders 
that many persons are deceived, and suppose the 
uave never shed all their double Teeth. 

5. 5. The crown of the second large grinder, o 
double tooth of the permanent set, in each jaw, stiL 
deep in its socket, the formation of its fangs not 
naving commenced. 

The subject was too young to allow of exhibiting 
the rudiments of the wisdom Teeth, or third large 
grinders. These are formed still farther back than 
the others. 



FORMATION OF THE TEETH. 

1. Formation of the Milk Teeth. 

When the rudiments of the Teeth are first disco 
verable, they are small gelatinous or pulpy bodies, 
enveloped in thin membranous sacks, and arranged 
in a sort of excavation or groove in the jaw, which 
at this time is but imperfectly formed. Bony fibres 
then shoot across this groove, and separate it into 
distinct cells, each of which contains its proper pulp, 
or embryo tooth, invested in its membrane. At the 
'me of birth, the formation of the temporary Teetli 
has generally so far advanced, that the pulps have 
attained their full size, and ossification has extended 
over their surfaces in such a manner as to form 
complete bony shells of the size and figure of the 
crowns of the Teeth; and the pulp of the first pep- 
manen ; grinder, on each side of both jaws, has ac- 
quired a considerable magritude. After this the 



The Teeth. 219 



pulps begin to elongate, in order to form the fangs, 
and the process of ossification is continued for the 
same purpose till they are completed. 

While this process is going on at the roots, anothei 
is progressing at the crowns, by which an earthy 
substance is deposited on their surfaces, and gradu- 
ally formed into that highly polished and beautiful 
covering, called the enamel. 

And while these changes are taking place, the 
Teeth are gradually rising, the alveolar processes 
which are to support them are increasing in height, 
and the membranous envelopes are dissolved and 
taken up by innumerable absorbing vessels, and car- 
ried into the mass of blood, having effected the pur 
pose for which they were formed. After this, the 
gums, or those parts of them which are situated im- 
mediately over the Teeth, are also absorbed, and the 
advancing Teeth are allowed to rise into view. 

The age at which the Teeth begin to appear, is 
usually that from the sixth to the eighth month; 
sometimes earlier, and often much later. They ge- 
nerally advance in pairs, and in the following order: 

1. The two central front Teeth of the under jaw 
which are soon followed by the corresponding ones 
in the upper jaw. 

2. The two next front Teeth, or lateral incisores of 
the under jaw, which are succeeded by the corres- 
ponding upper ones. 

3. The smallest double Teeth, first in the tmder, 
and then in the upper jaw. 

4. The under canine Teeth, which are followed 
by the upper ones, called the eye Teeth. 

5. The largest double Teeth. These also appear 
in the same order, with respect to the jaws, first in 
the under, and then in the upper one. They often 
pass through the gums at about the same time that 
the canine Teeth do, and sometimes before them. 
At other times, the canine Teeth precede even the 
smaller grinders in their advancement. 

Though this is the order in which these Teeth 



220 Compendium of Domestic Medicine. 

generally appear, various circumstances produce the 
greatest irregularity in this process. The time which 
is occupied for their advancement varies much, 
though it is usually a period of about eighteen 
months, or two years. 

2. Formation of the Permanent Teeth. 

The formation of the second set of Teeth, is one of 
the most curious and interesting processes which is 
effected in the development of any part of the human 
frame. 

While the temporary Teeth are forming, and soon 
after ossification has commenced on their pulps, the 
rudiments of the permanent set may be discovered. 
They are connected with the membranous coverings 
of the temporary Teeth, and are contained in the 
same sockets with them. When the first set advance 
to their destined situation, this connexion is not d 
stroyed, but the permanent Teeth are left deep if. '«** 
jaw, and bony partitions are formed between thf 
sockets of the two sets. At a certain period aft^ 
the crowns of the permanent Teeth are formed, the 
partitions of bone, which separate them from the 
pockets of the other set, are absorbed, and they gradu- 
lly rise and occupy the space thus formed. To giv* 
Aace to these Teeth, the fangs of the temporary set 
.re then absorbed ; and in this way their crowns are 
inally deprived of all support, except a slight attach- 
nent to the gums, and are often removed by the 
rdinary pressure of the tongue against them. 



SHEDDING THE TEETH. 

The provision of nature for exchanging the two 

eets of Teeth, is as much calculated to excite our 

admiration, as the process by which they are formed. 

\nd there is no period at which the Teeth of children 

•quire more, if so much, attention and care. 



The Teeth. 221 



If the fangs of the temporary Teeth be slowly ab- 
gorbed, the permanent Teeth will generally come 
forward so as to appear as soon as the corresponding 
ones of the preceding set are shed; and in a majority 
of cases, without doubt, the whole process is per- 
formed by nature with such perfect regularity, that 
the interference of art would be at best but useless. 
In some cases, it would be detrimental to the forming 
and rising Teeth ; and in others, injudicious and cruel, 
from the unnecessary infliction of pain. Yet there 
are so many cases in which irregularity and deform- 
ty, with tneir usual consequences of disease and 
suffering, are produced, by the manner in which the 
permanent Teeth are allowed to advance, that it is 
highly important that all parents should be acquaint- 
ed with the situation of the two sets of Teeth in rela 
tion to each other, and with the changes which take 
place within the period of the second dentition. See 
plate, ante page 217. For it is only by their know- 
ledge of these, that they can be enabled to judge 
correctly when it is proper for them to interfere in 
removing the temporary teeth, and when it may be 
expedient or necessary to apply for the advice and 
aid of an experienced, and judicious dentist, to pre- 
vent the evils which often result from neglect or 
ignorance. 

If the permanent Teeth are discovered to be 
emerging from the jaw in such a manner that their 
position will be improper and injurious, or if they are 
inclined to any irregularity arising from the dispro- 
portionate growth of the Teeth and jaws, much may 
be done to prevent it by a seasonable removal of the 
temporary Teeth; but this should not be done by any 
wljo are ignorant of their liability to do mischief by 
taking the wrong Teeth, or by extracting them too 
early, or by removing loose Teeth only, when there 
may be the greatest necessity for extracting such as 
are perfectly tight, and in which the process of ab- 
sorption has hardly commenced. 

It is a very common opinion that the first Teeth 



£22 Compendium of Domestic Medicine. 

have no roots, and that they may therefore be ex 
tracted without injury, at any period. But nothing 
can be more incorrect; for the Teeth of a child have 
longer and larger roots, in proportion to the size of 
their crowns, than th* Teeth of an adult; and their 
connexion with the forming Teeth of the second set, 
at an early period, is such, that if they be extracted 
too soon, the violence done to the tender Teeth be- 
neath them may be so great as to prevent their for- 
mation from being completed, and they may never 
appear. 

Another prevailing opinion is, that the temporary 
Teeth should always be extracted as soon as they 
are discovered to be loose; and though this may 
generally be done without any bad effects, it is not 
so necessary as has been supposed, and in most in- 
stances is a useless interference ; and exposes children 
to suffer both fear and pain, which might as well be 
avoided; for the looseness of these Teeth, as has 
already been shown, is occasioned by the absorption 
of their fangs ; and there can be no surer evidence 
than this, that nature is doing her own work in due 
season, and needs not the aid of art to expedite it, or 
render it more perfect. 

Et is not by removing Teeth which are loose, but 
those which are firm, and have their fangs nearly or 
quite entire, that any advantage is obtained which 
will favour the regular advancement of the perma- 
nent set The best advice, therefore, that can be 
given on this subject, to parents, and those who have 
the care of children, is to examine the Teeth fre- 
quently, about the usual period of shedding (the 
sixth or seventh year); and if any of the second set 
begin to make tneir appearance, or there is an evi- 
dent swelling of the gums at the part where any of 
them are expected to appear, a sufficient number of 
the first Teeth should be extracted to allow a suffi- 
cient degree of room for the second, which are coni- 
ng forward. 

From what has been stated, however, it will rea- 



The Teeth. 223 



dily be seen, that when the temporary Teeth have 
become very loose and troublesome, they may be 
extracted indiscriminately, and by any person ; but 
when they remain firm, and the Teeth of the second 
set are coming forward in such a manner as to lap 
over each other, or appear in a double row, it is of 
the utmost importance to remove them, whether the 
process of absorption has commenced at their fangs 
or not, in order to give room, and restore regularity 
to the rising Teeth. 

It should be remembered, with regard to the exami- 
nation of the jaws and Teeth at the time of shedding, 
that all the Teeth which are to succeed the first set, 
if they come forward too soon, or before the tempo- 
rary Teeth become loose, will be discovered behind 
them, or on the inner side of the jaw, excepting the 
eye Teeth, or cuspidati, which will be found advanc- 
ing on the outer side of the jaw. It sometimes hap- 
pens, also, that when the temporary grinders have 
been very early removed, the bicuspides, or small 
grinders, of the second set, make their appearance 
on the outer part of the jaw, next the cheek. This 
is most common with the upper ones. 

All cases of great irregularity (which may gene- 
rally be discovered before the teeth have risen far 
above the gums, and often as soon as they appear) 
should without delay be placed under the care of an 
experienced dentist ; for the limited knowledge which 
parents usually obtain, from the few cases which 
come under their observation, is not sufficient to en- 
able them to judge what is proper to be done, with 
that degree of correctness which the nature of tho 
•ubject requires. 



THE FIRST DENTITION. 

The age at which the first Teeth begin to appear, 
varies very much in different children. This is 
caused by various constitutional peculiarities; some- 



224 Compendium of Domestic Medicine. 

times it depends on the general vigour of the system 
when there is no predisposition to disease of any 
kind. It may likewise depend on the influence of 
various morbid principles which have been inherited 
from the parent, or on that of diseases produced by 
various external causes. Children of the most robust 
constitutions do not always begin to cut their teeth 
earlier, or get through this process in a shorter time, 
than many others that are of a more sickly and feeble 
habit ; yet the former are much less liable than the 
latter to suffer from the pains and diseases to which 
children are exposed during the period of dentition. 

The common expression of cutting the teeth, has 
arisen from an opinion, that the growing teeth make 
a passage for themselves through the gums by lace- 
ration ; which certainly is not the case. As the teeth 
rise, a waste or absorption of the gums takes place, 
in order to let them pass through. This is often 
effected so easily as not to occasion any symptoms of 
pain or uneasiness. The absorption of the gums, to 
make way for the teeth, is as certain an effect of na- 
ture as the growth of the Teeth. In many cases, how 
ever, the rapid advancement of the Teeth, and the 
changes which must necessarily take place to produce 
it, produce also much disturbance about the jaws, 
md in the system generally. The gums appear 
swollen and inflamed, there is an increased flow of 
saliva, the infant is restless, cries, and frequently 
puts its hands to its mouth. From the effects of local 
inflammation and nervous sympathy, the whole body 
may become dangerously affected; in such cases 
the most sudden and happy effects have been pro 
duced by lancing the gums. This operation is a 
very simple, but not an unimportant one, as will be 
seen in our remarks (subsequently) on the mode 
of performing the operation. It is often attended 
with the most unexampled benefit to the child, and 
should never be neglected when required 

Whatever contributes to promote the healthfu 1 
operations of nature, will make Teething easy ; such 



The Teeth, 225 



as frequent bathing in warm or cold water, according 
to circumstances, friction of the body and limbs, good 
air, exercise, and wholesome food ; and above all, a 
cool and open habit of body. The gums should be 
rubbed with the finger, and the child should be al- 
lowed the use of its own fingers m its mouth. The 
idea that a child's sucking its fingers will prevent 
their growth, is a prejudice without foundation in 
truth. 

The old and erroneous opinion, that the Teeth, as 
they grow, cut their way mechanically through the 
gums, first suggested the idea of assisting them in 
their protrusion, by the friction and pressure of hard 
substances; and hence arose the cruel and hazardous 
practice of scratching the gums through with the 
finger nail, or with pieces of hard loaf sugar, a prac- 
tice which has loo often been the cause of severe 
local and general suffering, if not of death, from the 
inflammation, fever, and spasms, which it has conlribu- 
ted to excite. Hence also the use of the coral and other 
hard smooth substances given children to bite ; which 
are most dangerous instruments put into the hands 
of children to destroy themselves; for as the Teeth 
rise, and become slightly elevated above the edges 
of their sockets, those hard substances press and 
bruise the gum between them and the sharp points, 
or edge of the tooth underneath : inflammation and 
its consequences undoubtedly follow; and in this 
way, w T e are fully persuaded, the lives of thousands 
of children are lost. 

The second dentition, or protrusion of the perma- 
nent Teeth, is seldom the cause of any suffering, ex- 
cept when ihe last grinders, or wisdom-teeth as they 
are called, are passing through the gum, being at the 
same time situated farther back than usual, and in 
audi a manner as to present their pointed surfaces 
towards the cheek; in which case, the motion of the 
jaw in mastication, occasions such a degree of press- 
ure on the gums and surrounding parts, as to produce 
much irritation, often a considerable degree of in 
P 



226 Compendium of Domestic Medicine. 

flammation about the jaw, and even ulceration. 
These circumstances sometimes render it necessary 
to extract these teeth, though in most cases they may 
be preserved, and the troublesome complaints re- 
moved by cutting away a small portion of the inflamed 
gum over the teeth, or by other timely and judicious 
treatment. 



DISEASES ATTENDING DIFFICULT DENTITION. 

In infancy, every part of the system is highly sus- 
ceptible of morbid impressions, and one set of organs 
readily becomes diseased through sympathy with 
another. 

Among the diseases to which children, while 
teething, are liable, are, general irritation, or fever 
of an inflammatory kind, eruptions on the skin, diar- 
rhoea, dysentery, cholera, inflammatory affections of 
the lungs and throat, swelling of the glands about 
the throat and neck, spasmodic affections of the limbs, 
and often convulsions of the whole frame. 

What has commonly been called the fever of 
teething children, makes its appearance several 
times in the course of the period occupied for cutting 
the teeth; often commencing very suddenly, and 
marked by a dulness and heaviness of the eyes, unu- 
sual heat of the skin, quickened respiration, coated 
tongue, loss of appetite, and restlessness. 

When these cases occur, it will be proper foi the 
parent or nurse to administer some mild emetic, or 
gentle cathartic medicine, and place the little patient 
for about ten minutes in a warm bath, as high as the 
waist. But if these do not give relief, and remove 
the principal symptoms of the complaint, no delay 
should be allowed in calling medical assistance- The 
doubtful aid of inexperience should no longer be 
trusted. 

When there is an eruption, which has become in 
any degree troublesome; the parts should be carefullv 



The Teeth. 227 



washed once or twice a day with castile soap suds, 
or warm milk and water, and covered with hair 
powder, or dry wheat flour; or smeared with olive 
oil, and covered with lint. No medicated ointment 
applied with a view to dry up, or scatter the erup- 
tion, should be used, or can be used with safety, 
without previous medical advice. 

The bowels of infants, while they are Teething, 
are not unfrequently affected in such a manner as to 
produce the most alarming consequences in a very 
short time. Sometimes, however, they remain in a 
diseased state for several weeks; the child at the 
same time continuing lively and playful, with a good 
appetite ; so that the sympathetic affection of these- 
parts appears to be but a salutary effort of nature, to 
relieve the system from other and more serious diffi- 
culties, or to prevent their occurrence. 

The very common practice, both of mothers and 
nurses, of dosing infants 4hat are suffering under 
diarrhoea or dysentery, with paregoric, anise, burnt 
brandy, and sugar, and various astringent prepara- 
tions, cannot be too seriously condemned. It is a 
practice which but too often serves to drive to a fatal 
close, a disease which, if it had been treated by a 
skilful hand, or even left to the kind efforts of nature, 
might have been conducted to a happy termination. 

Concerning most of the other diseases which have 
been enumerated, few parents possess a sufficient 
degree of knowledge of them, to be enabled to de- 
termine what is best to be done; and, indeed, the 
anxious concern which most parents feel for their 
suffering offspring, generally unfits them, more than 
any other circumstance, for a calm and deliberate 
exercise of their judgment. 

Delay in giving the attention which is often re- 
quired by children, when they begin to suffer from 
teething, is a fault of too common occurrence, and of 
too inexcusable a nature, to be passed wholly unno- 
ticed. The various maladies which attend the age 
of infant dentition, should not be suffered to prev on 



228 Compendium of Domestic Medicine. 

the constitution, while the too often fallacious hopt 
is cherished, that all will be well when the child 
has finished cutting its teeth; for, changes are not 
unfrequently produced in the system, which effect a 
lasting injury, and prevent the enjoyment of perfect 
health through the remainder of life. It may be 
asked, does the cutting of the milk-teeth require 
the aid of the dentist? Certainly not; it is generally 
a benign operation; but there are cases in which 
maternal solicitude has need of counsel; and the 
physician as dentist, or the dentist who is a phy- 
sician, in this case, will show what is requisite to be 
done. 

In almost every complaint attending diffic It den 
tition, the operation of dividing the gums with a 
lancet over the rising Teeth, is of very great import* 
ance, and cannot be too strongly recommended ; for, 
in many instances, it prevents the necessity of em- 
ploying any other remedy, and often exceeds all 
others in efficacy. In cases of great inflammation 
about the gums, attended with fever, the operation 
is often followed by the sudden cessation of pain, 
and the mitigation of every symptom of irritation; in 
diseases of the bowels, by the perfect removal of 
the most distressing symptoms, and a speedy return 
of the healthy action of the parts ; and in spasms 
of the limbs, and general convulsions, by the imme- 
diate interruption of the paroxvsms, and a prevention 
of their recurrence. Its salutary effects are so power- 
ful and decisive, that in all painful cases of dentition 
marked by evident swelling and inflammation of the 
gums, it should be performed without delay. 

The prejudices which still exist against the opera- 
tion, greatly prevent the extension of its usefulness ; 
but it is one which is perfectly simple and safe, when 
performed by any one acquainted with the anatomy 
of the infant jaw, and the relative situation of the 
two sets of Teeth. The accidents which have oeen 
kn' wn to follow it, are among the common fruits ol 
ignorance and presumption It is so far from being 



The Teeth. 22b 



painful or cruel, as is by many supposed, that infants, 
which a moment before were writhing and crying 
with pain, are sometimes known to laugh in the face 
of the operator before he has finisned the incision ; 
so sudden, and so great, is the relief which they ex- 
perience. 



DISEASES OF THE TEETH. 

The diseases to which the Teeth are subject, 
attack them in various ways, and present very differ- 
ent appearances. In some instances, owing to the 
peculiar nature of the disease, or the constitution of 
the Teeth, they are destroyed without causing any 
considerable degree of suffering, or giving rise to 
any disease of the surrounding parts; in others, not 
only the Teeth are affected in the most troublesome 
and painful manner, but the diseases originating in 
them, are extended to the gums, palate, tongue and 
other parts of the mouth, producing fungous and 
fleshy tumours about the gums and cheeks, deep- 
seated abscesses, and caries or rottenness of the 
bones. 

The Teeth, owing to their particular nature and 
situation, are subject to some diseases which are 
peculiar to them, and to others which are of a cha- 
racter very similar to that of the diseases which 
affect other bones. They are also, like most of the 
other bones, liable to fracture, dislocation and other 
accidents. Hence it must be evident, that in some 
instances, they will require a peculiar treatment, 
while in others the same surgical principles must be 
adopted, which are observed in the treatment of dis- 
eases and accidents of the other bones. 



230 Compendium of Domestic Medicine. 



Caries or Rottenness* 

The first disease to be mentioned, and that which 
is by far the most common, is caries, or rottenness of 
the Teeth. This commences in different parts of the 
Teeth, and is produced by several causes. It some- 
times commences in the internal part of the crown, 
and gradually extends till much of this portion of the 
tooth is destroyed. The enamel is rendered thin by 
the progress of the disease within, and finally breaks 
by a very slight r ressure. In other cases, its first 
effects are discovered on the enamel, which is dis- 
coloured, and becomes of a black or brown appear- 
ance ; its substance is decomposed, and in many cases 
it cleaves from the bony portion of the tooth, by 
which the progress of decay is for a long time arrest- 
ed ; but more frequently, when suitable means are 
not adopted to prevent it, it soon extends from the 
enamel to the softer and more sensibly organized 
parts of the tooth. 

In all cases, black and uneven cavities are pro- 
duced, which serve to give lodgement to particles 
of food; and these, mixing with the fluids of the 
mouth, readily undergo a putrefactive process, and 
hasten the destruction of the Teeth. 

By the progress of caries, also, the principal nerves, 
which supply the natural cavity in the tooth, become 
exposed not only to sudden changes of temperature, 
but to pressure from mastication, to the irritating 
contact of the tooth-brush, tooth-pick and other sud- 
stances; and hence, pain and inflammation are pro- 
duced, and the extraction of the tooth very commonly 
becomes the only means of preventing continued 
suffering. 

Cause? of Caries. — This affection of the Teeth is 
the consequence either of internal constitutional 
causes, or of those which are external and adventi- 
tious, and Aery commonly of both. Caries of the 
Teeth and even that of a peculiar character has 



The Teeth. 231 



been so often traced through whole families, from 
one generation to another; that this disease must be 
considered hereditary, as much as any to which the 
human system is liable. In numberless cases, caries 
appears to be the effect of some serious disease with 
which the individual had been afflicted while the 
Teeth were in the early stages of formation. With 
regard to the local or external causes, they are most 
commonly found to be collections of earthy and other 
foal substances, which have been suffered to form 
and collect about the Teeth, and also the use of inju- 
rious tooth-powders and washes. 

Treatment of Caries. — Although some Teeth are 
so constituted as to possess but little durability, and 
after the destroying power of caries once begins to 
operate on them, they go on rapidly to decay, in spite 
of all the aid which science and skill can afford; 
still, there are comparatively but few instances in 
which seasonable and judicious treatment will not 
arrest the progress of disease ; and even render Teeth 
serviceable for many years, which, if neglected, would 
soon be entirely destroyed. 

In the treatment of carious Teeth, it is of the 
utmost service to remove, by means of suitable in- 
struments, the whole of the decayed portion in all 
cases, leaving at the same time as much of the sound 
part of the tooth as possible. If this be not done, 
little, if any service is rendered by any operation ; and 
the Teeth go on to decay in the same manner after 
it has been performed as before. The surface of the 
tooth, where the decayed part is removed, should be 
ieft perfectly smooth, and if excavated, only in such 
a degree, that by the proper use of the tooth-brush, 
the lodgement of particles of food and other substances 
may be wholly prevented. 

Another mode of treating caries, and which most 
effectually prevents its increase, is that of filling the 
excavation, which has been formed by disease, with 
pure gold, or some other metallic substance. This 
operation, when properly performed, will generally 



232 Compendium of Domestic Medicine. 

preserve the Teeth from ten to twenty, and some 
times even thirty years, in a sound and serviceable 
state ; while at the same time it prevents all those 
unpleasant and painful occurrences to which a ca 
rious and hollow tooth is constantly exposed. 

The author has witnessed the salutary effects of 
this practice, in cases where the Teeth had been 
rilled with gold, for twenty and thirty years. In 
operations of his own, teeth have stood the test oi 
twelve years without any apparent alteration; and 
cases are recorded, in which the gold has preserved 
teeth in a perfectly sound and useful state, for a 
period of forty years. 

When by caries the natural cavity is laid open, 
and the principal nerves are exposed, the tooth often 
becomes too tender to bear the pressure occasioned 
by mastication, or the sudden changes of tempera- 
ture, and it becomes painful from the slightest causes 
After the disease has proceeded thus far, the Teeth 
may often be saved by filling them with gold, the 
nerves which supply the natural cavity first being 
destroyed. This the patient may do gradually, by 
carefully cleansing the cavity of the tooth of every 
thing which may be lodged in it, and applying a little 
lint soaked in some essential oil, as that of cloves or 
cajeput, which, if renewed two or three times a day, 
will, in a short time, have the desired effect. The 
nerves of such teeth are also sometimes destroyed by 
the dentist, in a more expeditious manner, by the use 
of strong mineral acids, or by instruments designed 
for this purpose. 

Although, from the time of the earliest writers on 
diseases of the Teeth, the operations of sawing and 
filing those which are carious have been recom 
mended and practised, they are seldom of service, 
are often injurious, and, in most instances, to say the 
best of tnem, are ineffectual and useless. The par- 
ticular objections to them will be noticed in some 
ubsequcnt remarks r m these operations 



The Teeth. 233 



Diseases of the Fangs of the Teeth. 

The disease, which has just been described, is one 
which has its seat in the crown and neck of a tooth < 
•ts progress being almost invariably arrested when it 
reaches the fang. But there are other diseases which 
attack this part, and which, though they do not sc 
commonly occur, are not less destructive in theii 
effects than caries. 

Cases of enlargement of the fangs, owing to an ac- 
cumulation of bony matter on various parts of them, 
are not uncommon, by which, not merely a single 
tooth is sacrificed, but one after another is lost, till 
in some cases, the patient is deprived of the whoh 
set, by this formidable and destructive disease. I 
commences with a dull pain in one side of the jaw 
which at times appears to be fixed in some particula 
tooth. Soon after the Teeth which have been mos 
painful are found to be loose, and the gums anf 
alveolar processes are gradually destroyed or ab 
sorbed, leaving the fangs without covering or sup 
port; the teeth are thus rendered useless, and toe 
troublesome to be borne, and must be extracted. 

A disease similar to one which affects the othe 1 
oones, and which has been called dry gangrene 
sometimes fixes on The Teeth. It commences ir 
the natural cavity of the tooth; the lining membrane 
and vessels connected with it are destroyed, and the 
crown of the tooth, before there is much pain, as 
sumes a dark blue appearance. A degree of inflam 
mation next commences in the articulating mem 
brane which connects the fangs with their sockc f s 
the gums acquire a dark red hue, are soft, and easily 
made to bleed. Matter is then formed ab^ui <hi 
roots of the tooth, and is discharged by sman op°n 
ings produced in the gums by the disease ; and ir 
this way the connexion of the tooth with the socke 
and the gums is destroyed, and the loss of it become* 
inevitable. 



234 Compendium of Domestic Medicine. 

These diseases, with others of a similar nature, 
extend in some cases to the bones of the face, so that 
abscesses and caries of the jaw are often connected 
with them, particularly as consequences of neglect 
or improper treatment- 

The causes of these diseases, though for the most 
part obscure, are sometimes to be traced to a connec- 
tion with some constitutional affection, or to blows, 
tails and various accidents. 

In the early stage of these diseases, or when they 
are first discovered by the patient, extraordinary care 
should be taken to brush and cleanse the Teeth 
and gums, which should be done two or three times 
daily. Benefit will also be found from the use of an 
astringent lotion, of tincture of Peruvian bark and 
rose water, in equal quantities, or a decoction of 
marsh rosemary, in the proportion of one ounce of 
the dried root to a pint of water. When these dis- 
eases have so far advanced, as to become serious 
and painful, the patient must not expect to combat 
them with advantage, unaided by the advice and 
particular direction of an experienced surgeon, o 
dentist. And it is of importance that those who may 
suffer from complaints of the above description, 
should be cautioned against confiding in the advice 
of ignorant persons — mere tooth-drawers, and quacks. 
The former will generally affirm that nothing is to 
be done but to extract the Teeth, wniie the latter 
will be ever ready to apply their infallible nostrums 
accompanied with a profusion of promises to cure all 
complaints, even those which they are sometimes 
pleased to call cancers of the mouth. 

Toothach 

Writers on the subject, have generally mentioned 
this complaint as a particular disease; whereas, a 
moment's reflection will show us that it is only a 
common symptom of disease. Pain in the Teeth 
or tootharh, is an almost invariable attendant on 



The Teeth. 235 



all the diseases which have been mentioned, and the 
mode of removing it varies with that of treating thf 
different diseases of which it is a symptom. If it b( 
induced by the exposure of the more sensible part of 
a tooth, as in case of caries, filling the cavity witr 
gold, or the other methods of defending the nerve? 
from the air, or destroying them, as mentioned above 
will be sufficient to remove it. If it arise from [n 
flammation about the root of the tooth, the same 
means should be used to subdue it, as in other local 
inflammations; and hence, in such cases, we find 
that cold water, or vinegar, cold meal-poultices, or 
strong irritating tinctures to the face, and a full dose 
of Glauber or Rochelle salts, are the most effectual 
in removing the pain. The too common practice of 
holding hot stimulating substances in the mouth, 
serves but to prolong the suffering. A momentary 
relief only is obtained, while the tongue and cheeks 
are smarting with each renewal of the medicine, but 
no permanent ease is experienced, till, by long suf- 
fering, fasting and watching, the patient becomes 
exhausted, and the paroxysm terminates in sleep. 

Very severe and almost unexampled suffering is 
sometimes caused by certain nervous pains to which 
the Teeth are liable, not only when they are ca- 
rious, or otherwise diseased, but even when sound. 
These, however, are generally sympathetic, and may 
be traced to some change in the habit or circum- 
stances of the system, particularly those to which 
the female constitution is liable, or to some disor- 
dered nerve, or other local difficulty. 

Toothach from rheumatism, though rare, if the 
Teeth are all sound, is very apt to occur when any 
of them are diseased; and the pain is not then con 
fined to the diseased Teeth only, but often extends 
jo the sound ones, and even from the Teeth of one 
side of the jaw to those of the other. 

Toothach is also a common attendant on a dis- 
ordered state of the stomach and olher digestive 
organs; and the suffering in these cases is generallv 



236 Compendium of Domestic Medicine. 

even more severe than when produced by othei 
causes, and is much less likely to be removed by any 
application made to the face or teeth only. 

When toothach is merely symptomatic of disease, 
or derangement in some other part or organ, it will 
most commonly yield to those remedies which are 
calculated to remove the original complaint. I£ 
therefore, it be in consequence of nervous pains 
about the face, or ear, use some strong irritating 
tincture, as that of camphor, Cayenne pepper, or 
flies, or the volatile liniment, applied externally ; 
giving at the same time a moderate dose of lauda- 
num, and repeating it if required. II it be attendant 
on a sudden attack of rheumatism, it will often be 
wholly removed by a full dose of volatile tincture 
of guaiacum, a warm bath. If derangement of 
the ordinary functions of the stomach and bowels 
induce it, an emetic, or a dose of some active 
cathartic medicine will in general procure relief. 

These internal remedies, however (as well as most 
others of a very active nature, which are applicable 
to the abovementioned cases), should, as much as 
possible, be administered under the direction of a 
physician, in order to guard against error, in judging 
of the nature of the case, and in the choice of medi- 
cines most suitable. 

Tartar, or Scurvy of the Teeth. 

This is a troublesome, and often a very destruc- 
tive complaint, and one which does much injury to 
the Teeth, even before those who suffer from it are 
aware of any danger. It does not originate from any 
particular state of the teeth alone, or from a disor- 
dered state of the gums and alveolar processes, as 
many are led to suppose; but is owing to an accu- 
mulation of earthy matter deposited from the saliva 
With some individuals, it collects much faster than 
with others; so that, whereas one wil have hi* 



The Teeth. 237 



teeth completely encrusted with it in a few weeks, 
if the proper means be not daily used to prevent it, 
another will pass a long life without any care of his 
teeth, and tartar will not collect on them at all; so 
much does its formation depend on the natural, or 
constitutional state of the fluids of the mouth. 

The tartar is seen on some teeth of a black or 
greenish colour, and very hard ; on others, brown or 
yellow, and not so firm in its consistency; but in all 
cases it is productive of incalculable injury to the 
Teeth, gums and alveolar processes. When it is 
first deposited on the Teeth, it is soft, and may be 
easily removed with a tooth-brush ; but if suffered to 
remain, it soon acquires a stony hardness, and gra- 
dually increases in thickness about the necks of the 
Teeth ; the gums become irritated and inflamed by 
it, the sockets are next destroyed, and the Teeth, 
being left without support, are often pushed out by 
the ordinary pressure of the tongue and lips. 

Tartar will in some cases collect to so great a 
degree on the Teeth of children as to produce a 
separation of portions of ihe jaw; and not only bring 
away the temporary teeth, but destroy those of the 
second set, which are beneath them. From this, and 
what has been before statea concerning the bad 
effects of tartar on the Teeth, it will readily be per- 
ceived how important it is to arrest the progress of 
so mischievous a complaint, in its earliest stage. 

With regard to the treatment of these cases, if the 
tartar has been suffered to become so hard as to 
require much force to remove it, the operation should 
be carefully performed, and without injuring the 
enamel, as is sometimes done, by the use of acids and 
files, practices which cannot be too severely cen- 
sured. The Teeth should be perfectly cleared of 
this foreign matter by sharp, cutting instruments, of 
a suitable form to effect the object without wounding 
and lacerating the gums. For the purpose of pre- 
venting the tartar from collecting again (or indeed 
from forming in the first place), and for restoring the 



238 Compendium of Domestic Medicine, 

gums to a healthy state, nothing more is requisite, 
generally, than the daily use of a stiff brush, and 
some suitable dentifrice (post page 245), or the as- 
tringent washes mentioned ante page 234. 

Many persons are in the habit of suffering their 
teeth to go without any efforts of their own for keep- 
ing them in order, and apply at stated periods to a 
dentist, to have the tartar removed from them; and 
this they do, no doubt, from the persuasion that it is 
all that is requisite for preserving them. But it may 
be important to state, for the information of those 
who are thus deceived, that the repeated collections 
of tartar, and frequent operations, do an injury to 
the Teeth which is not to be repaired by any sub- 
sequent care. The gums and alveolar processes are 
driven from them, they are deprived prematurely of 
that defence and support which these parts are de- 
signed to give, and are often lost many years before 
they would be, were a due degree of care bestowed 
on them. 



DISEASES OF THE ALVEOLAR PROCESSES. 

The alveolar processes commonly share in the dis- 
eases which affect the fangs of the Teeth ; but cases 
in which they are primarily diseased are very rare. 
A complaint which is most frequently met with in 
them, is a gradual decay, or wasting of the bony 
substance, attended with a certain degree of inflam- 
mation of the contiguous parts. A little pain, or 
uneasiness and swelling of the gums, are first expe- 
rienced ; the bone or process after this is very rapidly 
absorbed ; the affected teeth become loose, and ap- 
pear to be thrust forwards and out of their sockets, 
so that they are much longer than the rest. 

These cases, and particularly such as extend to 
the sockets of many or all of the Teeth, appear 
often to be caused by, or dependent on, a rheumatic 
or gouty affection of the whole svstem In the early 



The Teeth. 239 



stage of the disease the patient should take extraor- 
dinary care in brushing and cleaning The Teeth 
daily; and he may also use with advantage, the 
astringent washes recommended in the preceding 
chapter; by which, the progress of the disease will be 
much retarded, and the suffering greatly diminished. 

Preternatural enlargements of the alveolar pro- 
cess, or bony tumours, are sometimes found to arise 
on the jaws. They may readily be distinguished 
from those of a different nature, by their being much 
harder, and immovably fixed to the bone. They 
are not to be dissipated by any application made to 
the part, or by any internal remedy; and all attempts 
to do it, are, at best, but useless, and for the most 
part hazardous. In these cases, as in all others, the 
interference of quacks cannot be too scrupulously 
avoided, and the advice of an experienced surgeon 
should be seasonably obtained. Tumours of this 
kind do indeed increase very slowly, and if season- 
ably removed, are seldom injurious in their conse- 
quences. The fatal effects which they have some- 
times been known to produce, have been in con- 
sequence of deferring too long a safe and simple 
operation. 

Caries of the alveolar process is a common occur- 
rence, but it generally arises from some disease 
which has commenced in the Teeth, and from va- 
rious accidents to which these processes are liable in 
common with other parts. The patient has little to 
do for himself in these cases ; they for the most pari 
require surgical aid, and to be treated according to 
general surgical principles 



240 Compendium of Domestic Medicme. 



DISEASES OF THE GUMS. 

Inflammation and Sponginess of the Gums. 

This is the most common disease to which the 
gums are liable, and which, indiscriminately with 
That state of the Teeth which is produced by the 
accumulation of tartar, is often called scurvy. The 
effects of this disease are, a swelling of the gums, 
with a dark red, unhealthy appearance, great ten- 
derness, and liability to bleed. In very bad cases 
the gums are surprisingly thickened, and rise nearly 
to the tops of the Teeth. If the gums are suffered 
to remain for -a length of time under the effects of 
this disease, the sockets of the Teeth are destroyed 
by absorption and ulceration, and the Teeth them- 
selves drop out. 

The ordinary causes of the disease are, collections 
of tartar on the Teeth, long neglect of brushing the 
Teeth and gums, even when there is no tartar 
formed, the use of mercury, and a scorbutic state of 
the whole system. 

In order to prevent the ravages which this disease 
soon makes, if neglected, the gums should be brushed 
two or three times a day with the astringent washes 
which have been mentioned above. Powders, con- 
taining Peruvian bark, are often recommended ; in 
the worst cases, however, and particularly in those 
Whifh have been caused by the use of mercury, 
which renders the gums very irritable, no powders 
should be used ; but alternate mild and astringent 
lotions, such as warm water, or milk and water, fol- 
lowed by the application of a decoction of rosemary 
root, or hyson tea, the tincture of Peruvian bark, or 
a solution of alum, in the proportion of one drachm 
to a gill of water. 

If the inflammation and swelling of the gums bo 
produced by the accumulation of tartar, which is the 



The Teeth. 241 



most usual cause, this substance should be irnme 
diately removed. 

Gum-Boils. 

Small abscesses of the gums often appear over the 
roots of the Teeth, which are commonly called gum- 
boils. They do not, however, originate in the gum. 
but are produced by disease in parts beneath, most 
commonly by ulceration at the fang of a carious tooth. 
After matter is formed at this part, the inflammation 
is extended to the gum, and the process of ulceration 
is continued till the matter is discharged. 

After gum-boils have been thus produced, they 
often re-appear from very trifling causes, till a per- 
manent abscess is formed, from which matter is daily 
discharged. Although with some individuals these 
may remain for several months, or even years, with- 
out producing any serious consequences, particularly 
if the constitution be perfectly healthy; yet the inju- 
ries which sometimes result from them show, in a 
manner too painful and troublesome to be forgotten. 
that they deserve early and particular attention. It 
is important in all cases to open these abscesses with 
a lancet, to allow the matter to be discharged as soon 
as il is evidently formed; and when a permanent 
cure is not to be obtained, except by extracting dis- 
eased Teeth or stumps, this operation should be per- 
formed without delay. 

The operations which are required in the treat- 
ment of these cases, if attended to in season, are 
most of them too slight to be feared, and all of them 
much less painful than the extraction of a bad tooth 

Tumours of the Gums. 

Preternatural enlargements of the gums are not 
uncommon. They proceed from various causes, but 
generally from diseased Teeth; and are seldom to 
be cured till these are extracted. 
Q 



242 Compendium of Domestic Medicine. 

Tumours of the gums are either of a soft spongy 
texture, or of a more firm and fleshy nature, some- 
times nearly of the consistence of cartilage. All of 
them expose the patient to other and more serious 
evils, by causing a disease of the jaw, more or less 
extensive. The hard, fleshy, or cartilaginous tu- 
mours are not so common as those of the opposite 
nature; but their consequences are much more to be 
dreaded, if they are not early extirpated. They are 
sometimes found to be connected with a pre-existing 
disease of the jaws and Teeth, and at others, arise 
without any discoverable cause. In all these cases 
the speedy removal of the tumour (by the use of 
caustics, the ligature, or the knife) is the only plan 
of treatment on which we can reasonably depend 
for success. In some instances, however, the lace- 
ration produced by extracting Teeth which were 
enveloped in such tumours, has proved an effectual 
remedy. 



CLEANING THE TEETH. 

Highly important as this operation is to every in- 
dividual, there are too many who neglect it; "and, 
simple as is the process, there are many who, from 
habit, prejudice, or want of correct information, fail 
of performing it in a proper manner. 

As soon as the crowns of the first four permanent 
incisors, or front Teeth, have fully advanced through 
the gums, children should be provided with a suita- 
ble tooth-brush, and be taught the use of it. There 
are but few persons, whose Teeth do not require a 
considerable degree of care to keep them in a heal- 
thy and sound state, and more particularly to protect 
them from the rapid and injurious effects of caries, 
after they have become affected with this disease 
For many, the daily use of the brush and cold water 
is all that is required to keep the Teeth in perfect 
order; but most commonly, to effect this purpose, the 



The Teeth. 243 



use of dentifrice of some sort is found to be indis- 



With regard to the use of a brush, a moderately 
stiff one should be employed ; for a brush may be 
too soft to be of any service, or so hard as to irritate 
firm and healthy gums. The Teeth should be brush- 
ed both morning and evening, but more particu- 
larly in the morning, as the causes which favour the 
accumulation of tartar operate most powerfully 
during the hours of sleep. Brushing them once a 
day, however, if it be done faithfully, is preferable 
to many hasty and imperfect attempts to clean them. 
Merely to pass the brush a few times hastily over 
the teeth, is of little service ; five minutes or more 
should be diligently spent in performing this opera- 
tion. It is also a very useful practice, to brush the 
Teeth always after eating, particularly if they are 
very uneven, or affected with caries. 

The idea that the enamel of the Teeth can be in- 
jured by brushing, is as false and ridiculous as it 
would be to suppose that the palms of the hands may 
be worn out by moderate labour. The brush should 
not only be passed from side to side of the mouth, 
on the outer surfaces of the Teeth, but on the inner 
parts of them, next the tongue and roof of the mouth ; 
also upwards and downwards, from the gums of one 
jaw to those of the other When the Teeth have 
been seasonably attended to in the manner above 
directed, the necessity for using dentifrice or tooth- 
powder, is very much diminished, if not wholly su- 
perseded ; and there will be no case in which the 
use of it will be required oftener than once or twice 
a week. It should be remembered that it is not by 
merely spreading the powder over the surfaces of 
the Teeth with the brush, and then rinsing it off, that 
it is to have its proper effect; but by faithfully rub- 
bing it for several minutes on all parts of the Teeth 
which are exposed to the action of the brush, taking 
eare afterwards to remove every particle of it by the 
use of the brush and water, because, if left to lodge 



244 Compendium of Domestic Medicine. 

about the Teeth and gums, it aids the formation of 
tartar. The water may be used cold or warm, at 
can best be borne, but cold is preferable. 

Care should be taken in providing tooth-powder 
that it do not contain any substance that will act 
either chemically or mechanically on the Teeth, to 
injure them. Emery, pumice stone, and varioui 
acids are not unfrequently detected in those denti- 
frices and washes for the Teeth and gums, which 
are advertised as infallible in rendering tfte Teelh sur- 
prisingly white, dissolving and removing tartar, pre- 
venting decay, toothach, fyc. fyc. These may im- 
prove the appearance of the Teeth for a day, but in 
many instances ruin them for ever. 

Many persons, ignorant and unsuspicious of any 
evil consequences, are induced to use acids, some- 
times concentrated lemon juice, but more generally 
diluted vitriol, because they give the Teeth at once 
a beautiful white appearance. 

But few, however, have done this, without having 
to lament a most serious injury, or the total loss of 
their Teeth ; for in a short time, they become of a 
dead chalky white, soon turn dark coloured, and be- 
gin to decay and crumble to pieces, leaving the fangs 
in their sockets, more generally exposed to pain and 
inflammation, than if the crowns had been destroyed 
by any other cause. These baneful effects of acids 
cannot be too strongly impressed on the mind of 
every one ; for they are so often used by the unwary, 
even at the present day, that scarcely a week passes, 
in which the writer has not an opportunity of wit- 
nessing some new case of the evils sustained by the 
pernicious practice of cleaning the teeth with an 
acid lotion of dentifrice. 

We present to our readers the following recipe for 
a tooth-powder, which we can conscientiously recom- 
mend, for keeping the Teeth clean and rendering 
them white. It is perfectly harmless; and few per- 
sons will find it necessary to use it oftener than three 
times a week Although a little used every morn- 



The Teeth. 245 



ing will be found beneficial. Any one can have 
it manufactured by a druggist from the subjoined 
recipe : — 

Powdered Orris Root, 4 ounces, 

Prepared Chalk, 4 ounces, 

Powdered Cinnamon, £ ounce, 

Bicarbonate of Soda, £ drachm, 

Oil of Rose, 2 drops. — Mix. 
In order to cleanse and preserve artificial Teeth, 
the above directions should be carefully observed. 
It is necessary to add, however, that these Teeth 
require more frequent attention than natural ones, 
and that they should always be cleantd with a soft 
brush, and the mouth be rinsed thoroughly at least three 
times a day, particularly after eating. If they are 
well made and well set, they will bear this treat- 
ment; and will appear better and last longer in con- 
sequence of it. 



OPERATIONS ON THE TEETH. 

The remarks which I shall offer under this head 
are not made with a view to describe particularly 
the various operations which are required in the 
treatment of diseases of the Teeth, but rather to no- 
tice some circumstances connected with a few of 
the most common of them, which it is important 
should be more generally understood. 

Extraction of the Temporary Teeth, when Diseased 

The temporary, or first Teeth, become often very 
soon diseased, and require an operation, that of 
plugging, extraction, or the removal of tartar. The 
importance of the latter will be seen by adverting 
to the observations on scurvy, ante page 237. With 
regard to extracting the temporary Teeth, it should 
be renumbered, that a child ought not to be depri- 
ved of them without due consideration. If at thf» 



246 Compendium of Domestic Medicine. 

age of four or five years, the front, or even the ca- 
nine Teeth, become carious, as they often do, they 
may be extracted ; but much better it would be to 
have them properly filled, and if, at this early pe- 
riod, the double Teeth are found to be decayed 
and painful, it will be advisable to defer extracting 
them as long as is consistent with safety, and at 
the same time to employ all suitable means to 
allay the pain, and to have the Tooth or Teeth 
cleaned from the decay and filled with gold. 
If there be inflammation and swelling of the jaw and 
face produced, the removal of the affected teeth 
should be no longer delayed; as deep abscesses, 
which break externally through the cheek, are not 
unfrequently the consequence; and ulceration, when 
it takes place, and exists for any considerable time 
about these teeth, is known even to injure the per 
manent ones which are forming beneath them. 

Lancing, or Cutting the Gums, at the time of Teething. 

The salutary effects of this operation were noticed 
in the reinarlts on Diseases of Dentition (ante page 
226); and they will be very generally perceived, 
when it is performed at a suitable time, and in a 
proper manner. It should never be done, excepting 
when there is evident swelling of the gums over the 
expected teeth, attended with undoubted signs of 
inflammation. These, however, should be ascer- 
tained by the surgeon, and not by the parents or 
nurses. Ineffectual and repeated operations will 
then be prevented ; and it will only be requisite that 
the lancet should be used by some one familiar with 
rhe anatomy of the infant jaw, and with the relative 
situation of* the two sets of Teeth at this period. 

As this treatise may occasionally fall into the hands 
of physicians, it may not, perhaps, be wholly unim- 
portant, that we should address to them, a few obser- 
vations on the above mentioned operation. 

Nothing, but an essential difference in performing 



The Teeth. 247 

the operation, could have given rise to the very op- 
posite opinions, which have been, and still are 
entertained by physicians with regard to its utility 
For, while many are fully convinced of its beneficial 
effects, some consider it as altogether useless, and 
others condemn it as injurious. 

When it is considered advisable to cut the gums, 
it should be done with a common broad-edged gum- 
lancet, and the incision made immediately over the 
Teeth which are about to appear, but over no others. 
The gum should not merely be scarified, but cut 
entirely through, as also the investing or capsular 
membranes, till the lancet is felt to grate against the 
enamelled surface of the Tooth. Should the edge 
of the lancet be placed a little too far towards the 
inner part of the jaw, particularly in cutting for the 
front and canine Teeth, although we may divide the 
gum, and feel that the edge of the instrument is re 
sisted by bone, it will probably be no other than the 
internal plate or transverse portions of the alveolar 
processes, and the objects of the operation will not 
be obtained. Some relief may be produced for a 
little while by the bleeding, but more frequently, 
the irritation of the gums will be increased. Besides, 
by making the incision in this manner, there is dan- 
ger of dividing or injuring the membranous and 
vascular connexion between the first and second 
sets of Teeth, and thereby injuring or destroying 
the permanent ones entirely. Therefore, in order to 
prevent any injurious consequences, as well as to 
render the operation most serviceable, the incision 
should be made towards the external plate of the 
alveolar processes, so as to avoid the connecting 
membranes and sacks of the permanent teeth, par- 
ticularly those of the incisores and cuspidatu Those 
of the bicuspides are more easily avoided, on accoun* 
of the flat and broad surfaces of the temporary grin 
tiers. 



248 Compendium of Domestic Medicine. 



Filing or Sawing the Teeth. 

This operation is often performed with a view to 
remove the black and defective parts of carious 
teeth, and to separate them in such a manner that 
the excavation formed by the disease may be more 
exposed to the action of the tooth-brush ; but in a 
majority of cases these purposes cannot be effected 
either by saws or files, the operation will therefore 
he unavailing, and the hopes of the patient disap- 
pointed. 

The particular objections to the use of these in- 
struments are: 

1. That they do not remove the whole of the decay- 
ed parts of the Teeth; and it is a fact sufficiently evi- 
dent to common observation, that the disease of 
caries is often communicated from one tooth to ano- 
ther by contact; and it is equally true that while 
any of the defective part of a tooth is suffered to re- 
main, the liability of that tooth to decay is much 
greater than if this part were entirely removed. 

2. That in all cases, the effect of sawing or filing 
is to deprive the Teeth, unnecessarily, of a great 
portion of their sound enamel, particularly when these 
operations are performed on the front teeth. 

3. That the crowns of the Teeth being broader 
than their fangs, they often crowd together in such 
a manner, that, by the repeated operations of filing 
to keep them separated, one quarter and sometimes 
one third of each tooth is sacrificed, by the use of 
these improper instruments. 

4. That separating sound teeth with the file or 
saw (or indeed with any other instrument) is a 
practice for which there can be no reasonable apol- 
ogy. The idea that they may be too close, and injure 
each other by lateral pressure, is altogether errone- 
ous ; and there are no just grounds for the belief, that, 
by this operation, they may be prevented from de 
caving. 



The Teeth. 249 



To these objections we may add, that filing the 
Teeth always gives them a square and artificial ap- 
pearance, and is one of the most disagreeable, and 
often painful, operations that is performed on them 
to many persons, even worse than that of extraction 

As a substitute for files and saws, it is now recom- 
mended to use, in the operations for caries, small 
crooked knives, and other cutting instruments, which 
are liable to none of the above objections, and which 
enable the operator to effect the first, and also the 
most important objects in the treatment of this dis- 
ease. 



Fitting Teeth with Gold or other Metals, 



This operation, which is called plugging the Teeth, 
is performed for the purpose of rendering teeth which 
have begun to decay more lasting and serviceable; 
and when it is seasonably and properly performed, 
it is effectual in preserving them for many years, 
very commonly from ten to twenty, and in some cases 
even forty years. 

There are often cases in which the diseased tooth 
will not bear the pressure which is required to fill 
it properly with gold; and then an amalgam of 
mercury and tin may be used in its stead. It is 
therefore best, in all cases where it is practicable, 
to use pure gold, which is too hard to be worn 
away by the ordinary process of mastication, and 
which will not be changed in its properties, or 
corroded, by any article of diet or medicine, ex- 
cepting mercury, when its use is long continued. 



250 Compendium of Domestic Medicine, 



Scaling the Teeth, or the Removal of Tartar. 

Although every person may prevent the accumu 
lation of tartar upon his teeth, by the means pointed 
out in the preceding pages, and may even remove i 
after it has acquired a very considerable degree of 
firmness ; yet it is very often allowed to collect for so 
great a length of time, and to become so hard, that 
an operation under the hands of the dentist is the 
only remedy. The doubts that are by some enter- 
tained concerning the necessity or usefulness of re- 
moving the tartar, originate in an imperfect know- 
ledge of the nature of the case, and from accounts of 
injurious treatment by ignorant operators. The 
effects which have followed the use of acids and 
files, to dissolve and remove this substance, have 
not failed to destroy the confidence of those who 
have ever submitted to such impositions. 

The operation, if skilfully performed, is simple, 
and seldom painful ; and will always be of service 
while the Teeth retain a sufficient degree of attach- 
ment to their sockets to make them worth preserving. 
ft should be performed in the manner which has 
been directed at page 237; and the mode of treat- 
ment there prescribed for preventing the necessity 
of its repetition, will, if adopted, always be effectual. 

Extracting Teeth. 

There is probably no surgical operation which is 
not of a very serious or dangerous nature, that is so 
much dreaded as the extraction of teeth. Yet it is 
not always so much the fear of pain, provided the 
tooth be well extracted, as that of having it broken, 
the jaw fractured, or the instrument slip or break in 
the operation. These are accidents, however, which 
seldom happen in the practice of a skilful operator* 



The Teeth. 25i 



but are generally attributable to ignorance or care- 
lessness. There are, indeed, circumstances some' 
times connected with every kind of surgical operation 
which increase the difficulty of performing it, and 
which are not in all cases to be foreseen ; yet they 
are extremely rare, and when they do occur, if 
science and skill be engaged, unfavourable results 
are often prevented. 

The accidents above mentioned do indeed too 
often happen; and they must continue to occur, 
while the operation is entrusted to persons merely 
because they have strength enough to extract a 
tooth, and presumption enough to undertake it. 
Many are willing to believe a man sufficiently skilled 
in this operation, because he can make the instru- 
ments with which it is performed ; but who would 
employ a person to remove a wen, amputate a finger, 
or open a vein, because he could manufacture a 
knife or a lancet? 

An idea is erroneously entertained, by many, that 
the instruments which are in common use for ex- 
tracting teeth are imperfect ; but this is not the case 
On the contrary, the Key, the Forceps, the Hook, and 
the Graver, or what has been improperly called the 
Punch, though simple instruments, are all very per- 
fect in their construction ; and, in their present im- 
proved form, are calculated to separate a tooth from 
its socket with as much safety and dispatch, and with 
as little pain, as are consistent with the nature of the 
operation. 

Much time has been expended, and great ingenuity 
exerted, to produce an instrument for extracting the 
double teeth in a perpendicular direction ; but every 
contrivance of this sort has been calculated to ope- 
rate by making pressure on one or more of the Teeth 
next that which is to be drawn. This circumstance 
has shown such instruments to be in a great degree 
useless, on account of the frequent unsoundness 01 
looseness of the Teeth on which the required press- 
ure must be made, or the defective state of the tooth 



252 Compendium of Domestic Medicine. 

to be extracted. Besides, these instruments are un- 
avoidably large, and sometimes so complicated that 
their application is inconvenient, and the operation 
necessarily slow and painful. 



ARTIFICIAL TEETH. 

The early loss of the natural teeth, which is often 
occasioned by disease, or by various accidents, and 
the pain and inconvenience which many individuals 
thereby experience, may be greatly diminished by 
the use of artificial teeth, provided they are well 
made and judiciously set. 

Artificial teeth have been in use for many years, 
and have been formed of various animal and min- 
eral substances, such as human and animal teeth, 
ivory, bone, <fcc. These have, however, given way 
in the present day or more modern times to the 
porcelain teeth, composed of mineral substances, 
the manufacture of which has been brought to such 
a high state of perfection that it requires no small 
degree of acuteness of observation to distinguish 
them from extremely natural teeth. And they 
may now be set so firmly as to be very useful, both 
in eating and speaking, as well as ornamental. 
Artificial teeth may be set from one to any num- 
ber required. They may be secured by wooden 
pivots to the fangs or roots of decayed teeth 
which are left in the jaw, or to the remaining 
natural teeth by clasps around them, or be fas- 
tened to a plate of rubber, silver, gold, or plati- 
num, which is held in the mouth by suction ; and 
they may be set generally without giving any 
pain or uneasiness. 



INDEX. 



Abdomen, Dropsy of, 73 
Abscess, 116 

Psoas, 117 
Accidents, 122 

Compound, 143 
Affection of Nerves of Face, 93 
Ague Cake, 59 
Amputation, 143 
Aneurism, 111 
Angina Pectoris, 94 
Anodyne Clyster, 160 



Artificial Teetb, 252 
Asiatic Cholera, 163 
Asthma, 47 

Bladder, Inflammation of, 70 

Stone in the, 72 
Brain, Compression of, 125 

Concussion of, 124 

Inflammation of, 37 
Beds for Travellers, 19 
Bleeding, 154 

from tne Nose, 41 

Piles, 116 
Bilious Fever, 30 
Blind Piles, 116 
Bites of Dogs, &c, 130 
Blindness, Night, 40 
Boils, 114 
Bougies, 155 
Blood, Spitting of, 49 

Vomiting of, 56 
Blotched Face, 106 
Bubo, 78 
Burns, 152 

Cancer, 87 

of Lip, 42 

of Penis, 78 

of Testicle, 80 

of Tongue, 43 
Catarrh, 47 
Chancre, 78 

Cramp in the Stomach, 53 
Cartilage in the Joints, 85 
Carbuncle, 114 
Carious Ulcer, 121 
Catalepsy, 90 
Catheters, 154 



Charcoal Poultice, 168 
Cramp, 91, 
Chest, Dropsy of, 51 
Cleaning the Teeth, 242 
Chicken Pox, 100 
Contents, 5 
Colds, 47 
Consumption, 49 
Cholera Morbus, 60 
Colic, 64 

Painter's, 65 
Chronic Rheumatism, 83 
Cholera, 163 

Compression of Brain, 124 
Concussion " " 125 
Contusion 123 
Contused Wounds, 129 
Compound Accidents, 143 
Cow Pox, 100 

Dance of St. Vitus, 95 
Diarrhoea, 83 
Diabetes, 73 
Difficulty of Urine, 70 
Dimness of Sight, 39 
Diphtheria, 45 
Diseases of Alveolar Pro- 
cesses, 238 

Gums, 240 
Dislocations, 139 

Lower Jaw, 140 

Collar-bone, 140 

Shoulder, 140 

Elbow, 141 

Wrist, &c, 141 

Thigh, 142 

Knee-cap, 142 

Leg, 142 

Foot, 142 
Division of Diseases, 23 
Drowning, 143 
Dropsy of the Abdomen, 73 

Chest, 51 

Knee-joint, 84 
Dropsy of the Scrotum, 79 
Dyspepsia, 174 
Dysentery, 61 

Ear, Inflammation of, 40 
Eye, - - 88 

253 



254 



IN DEX. 



Effervescing Mixture, 156 
Emissions, Involuntary, 77 
Encysted Tumours, 113 
Emollient Clyster, 160 
Enlargement of Uvula, 43 
Enlarged Spleen, 59 

Spermatic Vein, 80 
Epilepsy, 90 
Erysipelas, 96 

Mercurial, 93 
Extracting Teeth, 250 

Fainting, 88 
Flannel, 17 
Face, Affection of Nerves of, 

93 
Fractures, Arm, 135 

Collar Bone, 135 

Foot, 138 

Fore-arm, 136 

Knee-cap, 137 

Lower Jaw, 134 

Leg, 138 

Nose, 134 

Ribs, 136 

Thigh, 137 

Wrist, 136 
Felons, 115 
Fever, 26 

and Ague, 28 

Bilious, 30 

Hectic, 36 

Intermittent, 28 

Low Nervous, 32 

Putrid, 34 

Remittent, 30 

Simple Inflammato rj, 27 

Scarlet, 95 

Typhus, 32 
Fleshy Tumours, 112 
Fistula, 118 
Fits, 90 

Foreign Bodies in Throat, 151 
Fungous Ulcers, 119 

Ganglion, 113 
Glands, Inflamed, 86 
Gravel, 68 
General Rule, 15 
Gleet, 76 
Goitre, 88 
Gonorrhoea, 75 
Gout, 81 
to Boils, 241 



Hartshorne's Decoction, 160 
Headache, 38 

Sick, 191 
Heartburn, 54 
Heart, Palpitation of, 50 
Hectic Fever, 36 
Herpes, 103 
Hiccough, 53 
Hints to Travellers, 17 

Invalids, 21 
Hip-joint Disease, 84 

Introduction, 15 
Indigestion, 54 
Inflamed Glands, 86 

Ulcer, 119 
Inflammatory Fever, 27 

Rheumatism, 82 

Sore Throat, 44 
Inflammation of Brain, 37 

Bladder, 70 

Ear, 40 

Eye, 38 

Intestines, 59 

Kidneys, 68 

Liver, 56 

Stomach, 52 
Influenza, 47 
Intermittent Fever, 28 
Impotency, 81 
Incontinence of Urine, 72 
Incised Wounds, 127 
Indolent Ulcer, 120 
Intestines, Inflammation oj 

59 
Involuntary Emissions, 77 
Irreducible Ruptures, 109 
Itch, 103 

Jaundice, 57 

Joints, Cartilage in, 85 

Kidneys, Inflammation of, 68 
King's Evil, 86 
Knee-joint, Dropsy of, 84 

Lancing the Gums, 246 

Lip, Cancer of, 42 

Liver, Inflammation of, 56 

Locked-jaw, 92 

Low Nervous Fever, 32 

Measles, 99 
Mercurial Disease, 79 



INDEX. 



Mercurial Erysipelas, 98 
Ulcers of the Mouth, 42 
Medicines for Travellers, 18 
Mortification, 153 
Mouth,Mercurial Ulcers of,42 

Nettle-rash, 105 
Night-Blindness, 40 
Node, 78 
Nose, Bleeding from, 41 

Painter's Colic, 65 
Palpitation of Heart, 50 
Palsy, 91 
Preface, 3 
Penis, Cancer of, 78 
Pleurisy, 48 
Prescriptions, 156 
Piles, 115 

Blind, 116 

Bleeding, 116 
Pimples on the Tongue, 42- 
Poisoning by Acids, 146 

Alkalies, 147 

Antimony, 148 

Arsenic, 147 

Bismuth, 148 

Copper, 148 

Lead, 150 

Liver of Sulphur, 149 

Lunar Caustic, 148 

Mercury, 147 

Mushrooms, 151 

Opium, 150 

Phosphorus, 149 

Powdered Glass, 150 

Poisonous Fish, 151 

Salts of Tin, 148 

Saltpetre, 149 

Sal- Ammoniac, 149 

Spanish Flies, 149 

Tobacco, 151 
Polypus, 41 
Poultice, Charcoal, 160 

Yeast, 160 

Bye Meal, 160 
Psoas Abscess, 117 
Pulse, The, 25 
Putrid Fever, 34 

Sore Throat, 45 
Punctured Wounds, 129 
Purgative Clyster, 160 

Rash, Nettle, 105 



Remittent Fever, 30 
Reducible Ruptures, 108 
Rheumatism, Inflammatory 

Chronic, 83 
Ringworm, The, 105 
Round, 67 
Rules, General, 15 

for Invalids, 21 
Ruptures, 108 

Irreducible, 109 

Reducible, 108 

Strangulated, 109 
Rye-meal Poultice, 160 

Saline Mixture, 156 
Scalds, 152 
Scald Head, 104 
Scaling the Teeth, 250 
Scarlet Fever, 95 
Small Pox, 101 
Strangulated Rupture, 109 
Sprains, 124 

Spermatic Vein, Enlarged, 80 
Spleen, Enlarged, 69 
Steatomatous Tumours, 112 
Swelling of Tonsils, 44 

White, 85 
Sick-headache, 191 

Symptoms, 192 

Medicines, 193 

Diet, 196 

Drinks, 203 - 

Exercise, 206 

Change of Air, 207 

Other Cautions, 207 
Sight, Dimness of, 39 
Simple Inflammatory Fever, 

Scirrhus, 87 
Stings of Bees, &c, 131 
Spitting of Blood, 49 
Strictures, 77 

in the Throat, 46 
St. Anthony's Fire, 95 
St. Vitus' Dance, 95 
Scorbutic Ulcer, 121 
Scrofula, 86 
Scrofulous Ulcer, 121 
Scrotum, Dropsy of, 79 
Scudamore's Lotion, 159 
Scurvy, 106 
Sloughing Ulcer, 120 
Stone in the Bladder, 72 



256 



INDEX. 



6tomach,Cramp in the, 53 
Inflammation of, 52 



Sun-stroke, 89 


Ulcers, 119 


Suppression of Urine, 71 


Fungous, 119 
Indolent, 120 


Suspended Animation, 143 


from Cold, 145 


Inflamed, 119 


Drowning, 143 


Mercurial, of Mouth, 42 


Foul Air, 145 


" " Tongue, 42 


Hanging, 145 
Syphilis, 77 


Scorbutic, 121 


Scrofulous, 121 




Sloughing, 120 


Tape-worm, The, 67 


Venereal, 121 


Tartar of the Teeth, 236 


Urine, Dirhculty of, 70 


Travellers, Beds for, 19 


Incontinence of, 72 


Cold, 20 


Immoderate flow of, 73 


Flannel, 17 


Suppression of, 71 


Hints to, 17 


Uvula, Enlargement of, 43 


Medicines, 18 




Night Air, 20 


Venereal Ulcers, 121 


Towels and Soap, 19 


Warts, 79 


Water, 19 


Vinegar Whey, 157 


Teeth, The, 212 


Vomiting of Blood, 56 


Caries of the, 230 


and Purging, 60 


Diseases of the, 229 




Formation, 218 


Wine Whey, 157 
Whitlow, 115 


First Dentition, 223 


Shedding the, 220 


White Swelling, 85 


Structure of the, 213 


Worms, 66 


Testicle, Cancer of, 80 


White Thread, 67 


Tetanus, 91 


Wounds, 125 


Throat, Inflammatory Sore, 


Contused, 129 


44 


Incised, 127 


Putrid Sore, 45 


Punctured, 129 


Strictures in, 46 


Poisoned, 130 


Tobacco Clyster, 160 


of the Abdomen, 132 


Tooth-ache, 234 


Chest, 132 


Tongue, Cancers on, 43 


Ear, 131 


Pimples on, 42 


Joints, 133 


Ulcers on, 42 


Limbs, &c, 131 


Tonsils, Swelling of, 44 


Scalp, 131 
Tendons, 133 


Tumours, 108 


Encysted, 113 
Fleshy, 112 


Throat, 132 




Steatomatous, 


Yeast Poultice, 160 


Tympany, 75 




THE 


END. 



Typhus Fever, 32 



SEP 28 1900 



> 



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